NPI 1578580916
State of Oklahoma
Practice location
- Address
- 2323 S Harvard Ave, Tulsa, OK 74114-3301
- Phone
- (918) 293-2140
- Fax
- (918) 712-7164
Authorised official
- Name
- Autumn Nickelson
- Title
- Interim Executive Director
- Phone
- (580) 256-8615
Registered specialties (3)
Psychiatric Hospital
Primary
Mental Health Clinic/Center (Including Community Mental Health Center)
Medical Specialty Clinic/Center
Registry record
- NPI
- 1578580916
- Entity type
- Organization
- NPI issued
- 15 Jul 2006
- Record last updated
- 6 Sep 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.