Organization Name: | RUSTLING WINDS INC |
NPI Number: | 1891817664 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENDA REANA BUMPHUS (ADMINISTRATOR) |
Mailing Address: | 211 West Main Wilburton |
State: | OK US |
Postal Code: | 74578 |
Phone Number: | 9184651100 |
Fax Number: | 9184655658 |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |