NPIMap

Organization Active NPI

Waynoka Mental Health Authority

Doing business as Northwest Substance Abuse Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Waynoka, OK
National Provider Identifier
1942334768
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
76244 Issued in OK
Legal business name
WAYNOKA MENTAL HEALTH AUTHORITY
Doing business as
Northwest Substance Abuse Treatment Center
Practice address
1095 Nickerson St
Waynoka, OK 73860-1252
Phone
(580) 824-0674
Fax
(580) 824-0676
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Sidney Don Smiley, MED IN COUNSELING
Title
Chairman of the Trustee Board
Phone
(580) 824-0674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 76244 OK Primary

Addresses

Primary practice location

1095 Nickerson St
Waynoka, OK 73860-1252

Mailing address

PO Box 135
Waynoka, OK 73860-0135
Phone (580) 824-0674

Other identifiers 1

IdentifierTypeStateIssuer
54197143OtherOKTPIN NUMBER

Other names 1

  • Northwest Substance Abuse Treatment Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest Treatment Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942334768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738600135",
            "telephone_number": "580-824-0674",
            "fax_number": "580-824-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 NICKERSON ST",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738601252",
            "telephone_number": "580-824-0674",
            "fax_number": "580-824-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNOKA MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "CHAIRMAN OF THE TRUSTEE BOARD",
        "authorized_official_telephone_number": "580-824-0674",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MED IN COUNSELING"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OK",
            "license": "76244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPIN NUMBER",
            "identifier": "54197143",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Substance Abuse Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynoka, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.