KIAMICHI YOUTH SERVICES (NPI# 1669597647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669597647 |
| Entity Type | Organization |
| Organization Name | KIAMICHI YOUTH SERVICES |
| Other Organization Name | KIAMICHI YOUTH SERVICE, INC. |
| Practice Address |
4 Se A Ave Idabel OK 74745-4620 |
| Practice Telephone | 5802866671 |
| Mailing Telephone | 5802866671 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. DEBORAH D. LAWSON (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 5802866671 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 261QM0801X | OK | Agencies |
| Other Name | Type Code |
|---|---|
| Kiamichi Youth Service, Inc. | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | KIAMICHI YOUTH SERVICES | 1310 Se Washington St, Idabel, OK 74745-3446 |
| Street Address |
4 SE A AVE |
| City | IDABEL |
| State | OK |
| Zip Code | 74745-4620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568957348 | Home Run Healthcare | Family Medicine | 1425 East Lincoln Road, Suite A-3, Idabel, OK 74745 | 2018-06-25 |
| 1720457203 | Leann Tomlinson | Registered Nurse | 2002 E Lincoln Rd, Idabel, OK 74745 | 2015-09-15 |
| 1659795508 | Laura Rush | Optometrist | 902 Lincoln Road, Idabel, OK 74745 | 2014-02-13 |
| 1619301116 | White River Home Health | Home Health | 2100 East Washington Street Ste D, Idabel, OK 74745 | 2013-09-03 |
| 1922440999 | John Phillip Stone Scoggin | Counselor | 111 Canterbury Lane, Idabel, OK 74745 | 2013-07-19 |
| 1841576725 | Ayesha Shante Wyatt | Nurse's Aide | 1800 Hillcrest, Idabel, OK 74745 | 2011-10-24 |
| 1154569457 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 6 Southeast Avenue A, Idabel, OK 74745 | 2009-01-26 |
| 1417103854 | John Hoskins | Internal Medicine | 902 Lincoln Rd, Choctaw Nation Health Clinic, Idabel, OK 74745 | 2008-08-18 |
| 1801077045 | Rhonda Cheryl Rodgers | Counselor | 104 Ne Ave A, Idabel, OK 74745 | 2007-11-15 |
| 1326241548 | Beverly Gayle Jasper-hayes | Counselor | 104 Ne A - Avenue, Idabel, OK 74745 | 2007-06-06 |
| Find all providers in zip 74745 | ||||
| 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 |
|---|---|---|---|---|
| 1154569457 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 6 Southeast Avenue A, Idabel, OK 74745 | 2009-01-26 |
| 1407972847 | Kiamichi Council On Alcoholism and Or Other Drug Abuse, Inc. | Community/Behavioral Health | 104 N.e. Ave. A, Idabel, OK 74745-0689 | 2007-03-21 |
| 1194256420 | Dragonfly Counseling Services, LLC | Community/Behavioral Health | 17 S Central Ave, Idabel, OK 74745-4625 | 2017-03-27 |
| 1295154581 | Providence Service Corporation of Oklahoma | Community/Behavioral Health | 116 Se Ave N, Idabel, OK 74745-5234 | 2014-04-15 |
| 1639594542 | Southeastern Oklahoma Family Services, Inc. | Community/Behavioral Health | 4 Se Ave A, Idabel, OK 74745-4620 | 2014-02-28 |
| 1861704652 | Kiamchi Youth Services Inc | Community/Behavioral Health | 116 Se Ave N, Idabel, OK 74745-5234 | 2010-07-08 |
| 1043446479 | Alternative Opportunities, Inc | Community/Behavioral Health | 4 Se Ave A, Idabel, OK 74745-4620 | 2009-05-29 |
| 1982866778 | Sequelcare of Oklahoma | Community/Behavioral Health | 411 S Central Ave, Idabel, OK 74745-6059 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1427656909 | Against All Odds Youth and Family Services | Community/Behavioral Health | 2701 Nw 185th St, Edmond, OK 73012-9795 | 2020-10-15 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1477170322 | Glostars LLC | Community/Behavioral Health | 19704 Vivace Dr, Edmond, OK 73012-5232 | 2020-06-26 |
| 1780201798 | Canadian County Collaborative LLC | Community/Behavioral Health | 1703 Professional Cir Ste 201, Yukon, OK 73099-6498 | 2020-06-26 |
| 1235754458 | New Life Counseling Center | Community/Behavioral Health | 1206 N Hwy 81, Duncan, OK 73533-1790 | 2020-06-12 |
| 1770108946 | Meadow Hazelhoff Counseling, LLC | Community/Behavioral Health | 9524 Conners Way, Mcloud, OK 74851-8668 | 2020-06-12 |
| 1407477920 | Keetoowah Economic Development | Community/Behavioral Health | 16414 W 760 Rd, Tahlequah, OK 74464-1675 | 2020-05-06 |
| 1992336481 | Share More Ctc, LLC | Community/Behavioral Health | 2000 N Broadway St Ste B, Moore, OK 73160-4416 | 2020-02-03 |
| 1356981138 | Grand Lake Mental Health Center Inc | Community/Behavioral Health | 2225 N Union, Ponca City, OK 74601-1536 | 2020-01-09 |
| 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.