EASTERN OKLAHOMA YOUTH SERVICES, INC. (NPI# 1447594502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447594502 |
| Entity Type | Organization |
| Organization Name | EASTERN OKLAHOMA YOUTH SERVICES, INC. |
| Practice Address |
511 College Ct Tahlequah OK 74464-4747 |
| Mailing Address |
2626 S 14th St Suite A20 Mcalester OK 74501-7383 |
| Practice Telephone | 9184530600 |
| Practice Fax Number | 9184530628 |
| Mailing Telephone | 9184205325 |
| Mailing Fax Number | 9184205327 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | MR. KENT RYAN KELLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9184205325 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
511 COLLEGE CT |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-4747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407477920 | Keetoowah Economic Development | Community/Behavioral Health | 16414 W 760 Rd, Tahlequah, OK 74464-1675 | 2020-05-06 |
| 1982061115 | Rise Center for Recovery | Community/Behavioral Health | 223 N East Ave, Tahlequah, OK 74464-3249 | 2016-01-19 |
| 1922483627 | Consulting and Counseling for Community Change, Pllc | Community/Behavioral Health | 1313 Cathy Ave, Tahlequah, OK 74464-6609 | 2015-07-22 |
| 1861768384 | Shana Netherlain Davis | Community/Behavioral Health | 1624 Clayton Dr, Tahlequah, OK 74464-8004 | 2012-03-29 |
| 1609147149 | Lisa Ann Lillard | Community/Behavioral Health | 321 E South St, Tahlequah, OK 74464-4024 | 2012-01-13 |
| 1902177447 | Ramona L Burns | Community/Behavioral Health | 203 Jamestown St, Tahlequah, OK 74464-6627 | 2012-01-13 |
| 1417244179 | Melinda Shaver, Psy.d. | Community/Behavioral Health | 315 N College Ave, Tahlequah, OK 74464-2703 | 2011-07-01 |
| 1053641373 | Tenkiller Behavioral Services, Inc. | Community/Behavioral Health | 304 N Muskogee Ave, Tahlequah, OK 74464-2738 | 2010-01-08 |
| 1033443296 | Redefine U | Community/Behavioral Health | 2511 S Muskogee Ave, Tahlequah, OK 74464-5459 | 2009-09-21 |
| 1851521363 | Eagle Ridge Institute | Community/Behavioral Health | 109 W 2nd Street, Tahlequah, OK 74464 | 2009-07-17 |
| Find all providers in TAHLEQUAH | ||||
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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.