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Cletas Cottage Day Treatment Center

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Noble, OK

NPI 1386815215 · NPPES record last updated Apr 20, 2008

Key facts

NPI
1386815215
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
CLETAS COTTAGE DAY TREATMENT CENTER
Practice address
220 South 5TH St
Noble, OK 73068
Phone
(580) 925-3286
Fax
(580) 925-3924
NPI assigned
Mar 19, 2008
Organization subpart
Yes
Parent organization (as reported)
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER

Authorized official

Name
Mr. Casey H Anson
Title
Executive Director
Phone
(580) 925-8804

Corporate family (same tax ID) 30

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

View all 30

National Provider Directory

Tax ID family
Central Ok Family Med Ctr (31 organizations share this tax ID)
Part of
Central Ok Family Med Ctr

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

220 South 5TH St
Noble, OK 73068

Mailing address

PO Box 358
527 West Third Street
Konawa, OK 74849
Phone (580) 925-3286

Other providers in Noble, OK

All providers in Noble, OK · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.