Eagle Ridge

Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Guthrie, OK

NPI 1326202003 · NPPES record last updated Apr 12, 2018

Key facts

NPI
1326202003
Entity type
Organization (NPI type 2)
Primary specialty
Mental Illness Community Based Residential Treatment Facility 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
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 11

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

National Provider Directory

Tax ID family
Eagle Ridge Family Treatment Center (12 organizations share this tax ID)

Specialties & licenses

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

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

Other providers in Guthrie, OK

All providers in Guthrie, OK · Mental Illness Community Based Residential Treatment Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.