NPIMap

Organization Active NPI

Jack Brown Treatment Center

  • Children's Substance Abuse Rehabilitation Facility
  • Tahlequah, OK
National Provider Identifier
1780939223
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
JACK BROWN TREATMENT CENTER
Practice address
17091 S Muskogee Ave
Tahlequah, OK 74465
Phone
(918) 453-5501
Fax
(918) 458-0499
NPI assigned
Jul 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Authorized official

Name
Mr. Darren Dry
Title
Director
Phone
(918) 453-5519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X Primary

Addresses

Primary practice location

17091 S Muskogee Ave
Tahlequah, OK 74465

Mailing address

PO Box 397
Park Hill, OK 74451-0397

National Provider Directory

National Provider Directory
Tax ID family
Talking Leaves Job Corps21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1780939223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 397",
            "city": "PARK HILL",
            "state": "OK",
            "postal_code": "744510397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17091 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74465",
            "telephone_number": "918-453-5501",
            "fax_number": "918-458-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK BROWN TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "DRY",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "918-453-5519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.