State of Oklahoma
Organization Active NPI Community/Behavioral Health Agency · Enid, OK
NPI 1720152788 · NPPES record last updated Feb 27, 2013
Key facts
- NPI
- 1720152788
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- STATE OF OKLAHOMA
- Practice address
- 702 N. Grand
Northwest Center for Behavioral Health
Enid, OK 73701 - Phone
- (580) 234-3791
- Fax
- (580) 237-7711
- NPI assigned
- Nov 20, 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
702 N. Grand
Northwest Center for Behavioral Health
Enid, OK 73701
Mailing address
1222 10TH Street, Suite 211
Northwest Center for Behavioral Health
Woodward, OK 73801-3156
Phone (580) 571-3217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100646280D | Medicaid | OK |
Other providers in Enid, OK
- Richard E Staerkel
- Clark Staiger
- Jarree Dawn Stanford
- David Stanley
- State of Oklahoma
- State of Oklahoma - Osu Center for Health Sciences College of Osteopat
- State of Oklahoma Human Services
- State of Oklahoma Human Services
- State of Oklahoma Human Services
- Makenzie Renee Stegeman
All providers in Enid, 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.