NPIMap

Organization Active NPI

Specialized Alternatives for Families and Youth of Oklahoma, Inc.

  • Case Management Agency
  • Oklahoma City, OK
National Provider Identifier
1104992403
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF OKLAHOMA, INC.
Practice address
300 N Meridian Ave
Suite #280-N
Oklahoma City, OK 73107-6560
Phone
(405) 942-5570
Fax
(405) 942-5603
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Authorized official

Name
Mr. Marc Bloomingdale, M.S.
Title
Vice President of Operations
Phone
(817) 789-2611

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X

Addresses

Primary practice location

300 N Meridian Ave
Suite #280-N
Oklahoma City, OK 73107-6560

Mailing address

10100 Elida Rd
Delphos, OH 45833-9056
Phone (419) 695-8010

Other identifiers 3

IdentifierTypeStateIssuer
100710730EMedicaidOK
100710730AMedicaidOK
100710730DMedicaidOK

Other names 1

  • SAFY OF OKLAHOMA - OKLAHOMA CITY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Safy of Oklahoma - Lawton5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 N Meridian Ave
Ste 280N
Oklahoma City, OK 73107
Phone (405) 942-5570

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1104992403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339056",
            "telephone_number": "419-695-8010",
            "fax_number": "419-695-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MERIDIAN AVE",
            "address_2": "SUITE #280-N",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076560",
            "telephone_number": "405-942-5570",
            "fax_number": "405-942-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF OKLAHOMA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "BLOOMINGDALE",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "817-789-2611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710730E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710730A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710730D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFY OF OKLAHOMA - OKLAHOMA CITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.