NPIMap

Organization Active NPI

Cimarron Valley Therapeutic Service, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Woodward, OK
National Provider Identifier
1164590790
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
K8600113 Issued in OK
Legal business name
CIMARRON VALLEY THERAPEUTIC SERVICE, INC.
Practice address
1005 9TH St
Woodward, OK 73801-3131
Phone
(580) 254-2886
Fax
(580) 254-3548
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Steve W. Gates, M.B.S., LBP
Title
Program Director
Phone
(580) 254-2886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X K8600113 OK Primary

Addresses

Primary practice location

1005 9TH St
Woodward, OK 73801-3131

Mailing address

PO Box 1041
Woodward, OK 73802-1041
Phone (580) 254-2886

National Provider Directory

National Provider Directory
Tax ID family
Cimarron Valley Therapeutic Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164590790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1041",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738021041",
            "telephone_number": "580-254-2886",
            "fax_number": "580-254-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 9TH ST",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013131",
            "telephone_number": "580-254-2886",
            "fax_number": "580-254-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIMARRON VALLEY THERAPEUTIC SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "580-254-2886",
        "authorized_official_credential": "M.B.S., LBP"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "OK",
            "license": "K8600113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodward, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.