NPIMap

Organization Active NPI

Eagle Ridge Family Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Guthrie, OK
National Provider Identifier
1619130978
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
EAGLE RIDGE FAMILY TREATMENT CENTER
Practice address
1916 E Perkins Ave
1916 E Perkins
Guthrie, OK 73044-5804
Phone
(405) 282-8272
NPI assigned
Jul 8, 2008
Last updated
Jul 8, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
EAGLE RIDGE INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Ms. Patrice Darlene StaleyNPI 1588815344
Title
Primary Counselor
Phone
(405) 282-8272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

1916 E Perkins Ave
1916 E Perkins
Guthrie, OK 73044-5804

Mailing address

PO Box 1182
Guthrie, OK 73044-1182
Phone (405) 282-8272

National Provider Directory

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

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1619130978",
    "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": "405-282-8272",
            "fax_number": "405-282-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 E PERKINS AVE",
            "address_2": "1916 E PERKINS",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730445804",
            "telephone_number": "405-282-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDGE FAMILY TREATMENT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAGLE RIDGE INSTITUTE",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "STALEY",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "PRIMARY COUNSELOR",
        "authorized_official_telephone_number": "405-282-8272",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "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 Jul 8, 2008; 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.