NPIMap

Organization Active NPI

Eagle Ridge

  • Mental Illness Community Based Residential Treatment Facility
  • Guthrie, OK
National Provider Identifier
1326202003
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
EAGLE RIDGE
Practice address
1916 E Perkins Ave
Guthrie, OK 73044-5804
Phone
(405) 282-8262
NPI assigned
Jul 11, 2008
Last updated
Apr 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Cynthia Jane Willis
Title
Personnel & Compliance Officer
Phone
(405) 858-2821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X OK Primary

Addresses

Primary practice location

1916 E Perkins Ave
Guthrie, OK 73044-5804

Mailing address

PO Box 1182
Guthrie, OK 73044-1182
Phone (405) 282-8232

National Provider Directory

National Provider Directory
Tax ID family
Eagle Ridge Family Treatment Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1326202003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1182",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730441182",
            "telephone_number": "405-282-8232",
            "fax_number": "405-282-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 E PERKINS AVE",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730445804",
            "telephone_number": "405-282-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "PERSONNEL & COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "405-858-2821"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.