OCCIC (NPI# 1427423565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427423565 |
| Entity Type | Organization |
| Organization Name | OCCIC |
| Practice Address |
2625 General Pershing Boulevard Oklahoma City OK 73107 |
| Practice Telephone | 4058873190 |
| Mailing Telephone | 4058873190 |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |
| Authorized Official Name | MRS. DENEKA CAIN (EXECUDIRECTOR) |
| Authorized Official Telephone | 14059456230 |
| Authorized Official Credential | TIVE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Y000013649 | OK | Residential Treatment Facilities |
| Street Address |
2625 GENERAL PERSHING BOULEVARD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| 1699028597 | Dental Depot of 10004 South Memorial Drive Pllc | Dentist | 1918 N. Drexel, Oklahoma City, OK 73107 | 2012-10-17 |
| Find all providers in zip 73107 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285966747 | Dr. C Professional Services, Pllc | Community Based Residential Treatment Facility, Mental Illness | 7109 S Kentucky Ave, Oklahoma City, OK 73159-3427 | 2010-02-09 |
| 1447673819 | Red Rock Behavioral Health Services | Community Based Residential Treatment Facility, Mental Illness | 4130 N Lincoln Blvd, Oklahoma City, OK 73105-5209 | 2014-01-21 |
| 1053687780 | Community Couseling Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1700 Nw 17th St, Oklahoma City, OK 73106-4212 | 2012-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801321070 | April Brock | Community Based Residential Treatment Facility, Mental Illness | 106 12th Ave Ne, Miami, OK 74354-3373 | 2017-04-25 |
| 1114321486 | Cedric Glenn | Community Based Residential Treatment Facility, Mental Illness | 1721 E 72nd St, 1803, Tulsa, OK 74136-5372 | 2014-10-15 |
| 1083058523 | Mongo Allen | Community Based Residential Treatment Facility, Mental Illness | 829 Nw 142nd St, Edmond, OK 73013-1962 | 2013-04-27 |
| 1801133236 | Southeastern Oklahoma Family Services | Community Based Residential Treatment Facility, Mental Illness | 1501 N Washington Ave, Durant, OK 74701-2127 | 2013-01-04 |
| 1043595879 | Oaktree Counseling Services | Community Based Residential Treatment Facility, Mental Illness | 2104 Nw Britni Cir, Lawton, OK 73505-3121 | 2011-10-12 |
| 1790089829 | Southern Oklahoma Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 5862 Us Hwy 70, Mead, OK 73449 | 2011-01-04 |
| 1881921898 | Sequoyah Residential Mental Health Facility, Inc | Community Based Residential Treatment Facility, Mental Illness | 103 N Wheeler Ave, Sallisaw, OK 74955-4617 | 2009-11-11 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| 1558570309 | Meadow Brook Residential Care Facility | Community Based Residential Treatment Facility, Mental Illness | 1000 Meadow Lane, Howe, OK 74940 | 2007-05-21 |
| 1568580108 | Transition House, Inc. | Community Based Residential Treatment Facility, Mental Illness | 700 Asp Ave, Suite 2, Norman, OK 73069-4900 | 2007-03-26 |
| Find all providers with the same taxonomy | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
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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.