Rose Garden Clinic, LLC

Organization Active NPI Professional Counselor · Cache, OK

NPI 1316225212 · NPPES record last updated Jul 26, 2011

Key facts

NPI
1316225212
Entity type
Organization (NPI type 2)
Primary specialty
Professional Counselor 101YP2500X
License
2757 (OK)
Legal business name
ROSE GARDEN CLINIC, LLC
Practice address
509 West C Ave
Cache, OK 73527
Phone
(580) 429-2700
Fax
(580) 429-2701
NPI assigned
Jul 26, 2011
Organization subpart
No

Authorized official

Name
Mr. Eric Paul Christian Rosenquist, MS, LPC, LBP
Title
Lead Counselor
Phone
(580) 429-2700

National Provider Directory

Locations

509 W C Ave
Cache, OK 73527
Phone (580) 429-2700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YM0800X 0109 OK
Mental Health Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YM0800X CERT. SEX OFF TREATM OK
Professional Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YP2500X 2757 OK Yes

Addresses

Primary practice location

509 West C Ave
Cache, OK 73527

Mailing address

PO Box 181
Cache, OK 73527-0181
Phone (580) 429-2700

Other identifiers

IdentifierTypeStateIssuer
200334980AMedicaidOK

Other names

  • Rosenquist Counseling Doing business as

Other providers in Cache, OK

All providers in Cache, OK · Professional Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.