State of Oklahoma
Organization Active NPI Community/Behavioral Health Agency · Fairview, OK
NPI 1487727699 · NPPES record last updated Feb 27, 2013
Key facts
- NPI
- 1487727699
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- STATE OF OKLAHOMA
- Practice address
- Northwest Center for Behavioral Health
1425 N. Main, Suite 1
Fairview, OK 73737 - Phone
- (580) 227-2088
- Fax
- (580) 227-2349
- NPI assigned
- Nov 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Trudy Hoffman
- Title
- Executive Director
- Phone
- (580) 571-3233
Other NPIs on the same Medicare enrollment 23
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031125000846 | OK | Part B Supplier - Clinic/Group Practice | 4486558962 |
Receives reassigned benefits from 175 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Alva, OK; Woodward, OK; Tulsa, OK; Stigler, OK; Norman, OK; McAlester, OK; Lawton, OK; Kingfisher, OK… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
Northwest Center for Behavioral Health
1425 N. Main, Suite 1
Fairview, OK 73737
Mailing address
Northwest Center for Behavioral Health
1222 10TH Street, Suite 211
Woodward, OH 73801-3156
Phone (580) 571-3217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100749430A | Medicaid | OK |
Other providers in Fairview, OK
- Olivers Express Pharmacy LLC
- Robert a. Marti, D.D.S., a Professional Corporation
- Marilyn Ruffin
- Cassandra Lagayle Schlotthauer
- Drew Sharp
- Brandy Swanson
- Sierra Dawn Swanson
- Mary Watkins
- Amanda Lee Wiens
All providers in Fairview, OK · Community/Behavioral Health Agency in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.