MS. DOMONIQUE MONTRELL LUGRAND (NPI# 1174898852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174898852 |
| Entity Type | Individual |
| Full Name | MS. DOMONIQUE MONTRELL LUGRAND |
| Practice Address |
2220 S Santa Fe Apt 105 Moore OK 73160-5238 |
| Mailing Address |
2220 S Santa Fe Ave Apt 105 Moore OK 73160-2866 |
| Practice Telephone | 4056640415 |
| Mailing Telephone | 4056640415 |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Street Address |
2220 S SANTA FE APT 105 |
| City | MOORE |
| State | OK |
| Zip Code | 73160-5238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447521885 | Childrens Eecovery Center | Psychiatric Residential Treatment Facility | 2220 S Santa Fe Ave Apt 105, Moore, OK 73160-2866 | 2012-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053853655 | Brittany Jones | Psychiatric Residential Treatment Facility | 1707 Oak Ln, Miami, OK 74354-1429 | 2016-11-14 |
| 1376905976 | Kls Care Centers | Psychiatric Residential Treatment Facility | 17364 State Highway 9, Norman, OK 73072-8732 | 2016-03-23 |
| 1811370471 | William S, Davies, M.d., Inc. | Psychiatric Residential Treatment Facility | 1302 N, W, Lake Ave, Lawton, OK 73507 | 2015-07-01 |
| 1750719886 | Marylee Gaskins | Psychiatric Residential Treatment Facility | 302 E 19th St, Owasso, OK 74055-4612 | 2013-10-29 |
| 1144527227 | Riverside Behavioral Health | Psychiatric Residential Treatment Facility | 4618 S 31st West Ave, Tulsa, OK 74107-7532 | 2011-02-25 |
| 1760782882 | Lori Suzanne Frock | Psychiatric Residential Treatment Facility | 66 Overland Rt, Ardmore, OK 73401 | 2010-10-22 |
| 1215261086 | Brenda Sue Mathis | Psychiatric Residential Treatment Facility | 4034 W Roanoke Pl, Broken Arrow, OK 74011-1327 | 2009-09-28 |
| 1346424363 | Southern Plains Treatment Services | Psychiatric Residential Treatment Facility | 310 12th Ave Ne, Norman, OK 73071-5238 | 2007-12-27 |
| 1346461688 | Parkside, Inc. | Psychiatric Residential Treatment Facility | 1619 E 13th St, Tulsa, OK 74120-5410 | 2007-05-02 |
| 1164643409 | Parkside, Inc. | Psychiatric Residential Treatment Facility | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2007-05-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.