Doctor Name: | MRS. PHILISHA J AUSTIN |
NPI Number: | 1770975385 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., CADC |
License Number: | 322 |
Business Practice Address: | 13597 Se 202nd Rd Talihina, OK - 745716003 |
Business Phone Number: | 9185672905 |
Business Fax Number: | 9185672995 |
Mailing Address: | Po Box 185, CLAYTON |
State: | OK |
Postal Code: | 745360185 |
Phone Number: | 9185672905 |
Fax Number: | 9185672995 |
NPI Enumeration Date: | 02/19/2015 |
NPI Last Update Date: | 02/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 322 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |