NPIMap

Organization Active NPI

Refuge Behavioral Health PLLC

  • Clinic/Center
  • Tishomingo, OK
National Provider Identifier
1104193093
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4255 Issued in OK
Legal business name
REFUGE BEHAVIORAL HEALTH PLLC
Practice address
201 S Murray St
Tishomingo, OK 73460-2224
Phone
(580) 371-0321
Fax
(158) 037-1031
NPI assigned
Nov 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tyson Middle Ratzlaff, M.ED, LPC
Title
Owner
Phone
(580) 272-8012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4255 OK Primary

Addresses

Primary practice location

201 S Murray St
Tishomingo, OK 73460-2224

Mailing address

201 S Murray St
Tishomingo, OK 73460-2224
Phone (580) 371-0321

National Provider Directory

National Provider Directory

Locations

201 S Murray St
Tishomingo, OK 73460
Phone (580) 371-0321

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1104193093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MURRAY ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734602224",
            "telephone_number": "580-371-0321",
            "fax_number": "158-037-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MURRAY ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734602224",
            "telephone_number": "580-371-0321",
            "fax_number": "158-037-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFUGE BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "RATZLAFF",
        "authorized_official_first_name": "TYSON",
        "authorized_official_middle_name": "MIDDLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-272-8012",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED, LPC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "4255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tishomingo, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.