STATE OF OKLAHOMA (NPI# 1922171701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922171701 |
| Entity Type | Organization |
| Organization Name | STATE OF OKLAHOMA |
| Other Organization Name | NORTHWEST CENTER FOR BEHAVIORAL HEALTH |
| Practice Address |
1 Mile East U.S. Highway 270 Fort Supply OK 73841-0001 |
| Mailing Address |
Po Box 1 Fort Supply OK 73841-0001 |
| Practice Telephone | 5807662311 |
| Practice Fax Number | 5807662017 |
| Mailing Telephone | 5807662311 |
| Mailing Fax Number | 5807662017 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2013-03-29 |
| Authorized Official Name | TRUDY HOFFMAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5805713233 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100704080A | 05 |
| Other Name | Type Code |
|---|---|
| Northwest Center for Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225352057 | State of Oklahoma | Community/Behavioral Health | 400 North Oak, Taft, OK 74463 | 2010-03-23 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| 1124286059 | State of Oklahoma | Pharmacy | 304 Fairlane Ave, Sulphur, OK 73086-6861 | 2008-05-28 |
| 1154589430 | State of Oklahoma | Skilled Nursing Facility | 10014 Se 1138th Street, Talihina, OK 74571-6028 | 2008-05-23 |
| 1225295710 | State of Oklahoma | Skilled Nursing Facility | 1701 South 4th, Clinton, OK 73601-1209 | 2008-05-21 |
| 1881872182 | State of Oklahoma | Skilled Nursing Facility | 900 E. Airport Rd., Okmulgee, OK 74447 | 2008-02-08 |
| 1720152788 | State of Oklahoma | Community/Behavioral Health | 702 N. Grand, Northwest Center for Behavioral Health, Enid, OK 73701 | 2006-11-20 |
| 1750456588 | State of Oklahoma | Community/Behavioral Health | 1222 10th Street, Suite 211, Northwest Center for Behavioral Health, Woodward, OK 73801-3156 | 2006-11-20 |
| 1700950201 | State of Oklahoma | Substance Abuse Rehabilitation Facility | 5050 Williams Avenue, Northwest Center for Behavioral Health, Woodward, OK 73801 | 2006-11-17 |
| 1437222734 | State of Oklahoma | Community/Behavioral Health | 604 Choctaw, Northwest Center for Behavioral Health, Alva, OK 73717 | 2006-11-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF OKLAHOMA EAST CENTRAL UNIVERSITY | 1100 E 14th St, Ada, OK 74820-6999 |
| Street Address |
1 MILE EAST U.S. HIGHWAY 270 |
| City | FORT SUPPLY |
| State | OK |
| Zip Code | 73841-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553163 | Mirissa Joy Beavers | Social Worker | 193461 E. County Rd. 304, Fort Supply, OK 73841 | 2019-11-25 |
| 1801119128 | Stephanie Harper | Registered Nurse | 1 Mile E. Us Hwy 270, Fort Supply, OK 73841 | 2010-03-02 |
| 1265755581 | Penny Hills | Registered Nurse | 1 Mile E. U S Hwy 270, Fort Supply, OK 73841 | 2010-03-02 |
| 1982782181 | Patrick Scott Herd | Psychiatry & Neurology | Northwest Center for Behavioral Health, 1 Mile East On Hwy 270, Fort Supply, OK 73841 | 2006-11-02 |
| 1619290939 | Carrie Randall | Registered Nurse | 1 Mile E. Us Hwy 270, Fort Supply, OK 73841 | 2010-03-02 |
| 1528381845 | Sanzee Suthers | Registered Nurse | 1 Mile E. Us Hwy 270, Fort Supply, OK 73841 | 2010-03-02 |
| 1538482856 | Cathy Heinen | Registered Nurse | 1 Mile E. Us Hwy 270, Fort Supply, OK 73841 | 2010-03-02 |
| 1700109022 | Sharon Potts | Registered Nurse | 1 Mile E. Us Hwy 270, Fort Supply, OK 73841 | 2010-03-02 |
| 1669980173 | Laura S Brandvik | Licensed Practical Nurse | Po Box 1, Fort Supply, OK 73841-0001 | 2018-01-18 |
| 1932478070 | Angela M Myers | Nurse Practitioner | 193461 East County Road 304, Fort Supply, OK 73841-0001 | 2011-12-19 |
| Find all providers in zip 73841 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063968352 | Thomas Luiskutty Md Plc | Psychiatric Hospital | 6910 E 111th Pl S, Bixby, OK 74008-2066 | 2016-08-28 |
| 1770932410 | Oakwood Springs, LLC | Psychiatric Hospital | 13101 Memorial Springs, Oklahoma City, OK 73114-2226 | 2016-06-03 |
| 1104224856 | Erica Gregory | Psychiatric Hospital | 211 S Garnett Rd, Tulsa, OK 74128-1805 | 2014-12-11 |
| 1386983104 | Odmhsas | Psychiatric Hospital | 9803 Welch Dr, Oklahoma City, OK 73139-2814 | 2013-02-14 |
| 1437364080 | Oklahoma Forensic Center | Psychiatric Hospital | 24800 S. 4420 Rd., Vinita, OK 74301 | 2007-05-14 |
| 1437370772 | Parkside, Inc. | Psychiatric Hospital | 1619 East 13th Street, Tulsa, OK 74120-5410 | 2007-05-02 |
| 1740323245 | Red Rock Behavioral Health Services | Psychiatric Hospital | 4404 North Lincoln, Oklahoma City, OK 73105-5105 | 2007-02-14 |
| 1770599268 | Willow Crest Hospital, Inc. | Psychiatric Hospital | 130 A St Sw, Miami, OK 74354-6806 | 2006-08-01 |
| 1598716490 | Uhs Oklahoma City LLC | Psychiatric Hospital | 6501 Ne 50th St, Oklahoma City, OK 73141-9118 | 2006-05-15 |
| 1760481899 | State of Oklahoma | Psychiatric Hospital | 602 Sw 38th Street, Lawton, OK 73505-6912 | 2005-07-20 |
| Find all providers with the same taxonomy | ||||
| City | FORT SUPPLY |
| Zip Code | 73841 |
Please comment or provide details below to improve the information on STATE OF OKLAHOMA.
| 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.