Eagle Ridge Institute
Organization Active NPI Case Management Agency · Oklahoma City, OK
NPI 1104182633 · NPPES record last updated Apr 10, 2012
Key facts
- NPI
- 1104182633
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Management Agency 251B00000X
- License
- 7272 (OK)
- Legal business name
- EAGLE RIDGE INSTITUTE
- Practice address
- 601 NE 63Rd St
Oklahoma City, OK 73105-6407 - Phone
- (405) 840-1359
- NPI assigned
- Apr 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. John Mayfield, M.DIV.
- Title
- Executive Director
- Phone
- (405) 840-1359
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Eagle Ridge Family Treatment Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 7272 | OK | Yes |
Addresses
Primary practice location
601 NE 63Rd St
Oklahoma City, OK 73105-6407
Mailing address
601 NE 63Rd St
Oklahoma City, OK 73105-6407
Phone (405) 840-1359
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All providers in Oklahoma City, OK · Case Management Agency in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.