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Organization
CLETAS COTTAGE DAY TREATMENT CENTER
Active
Organization
CLETAS COTTAGE DAY TREATMENT CENTER
Active
Parent organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Authorized official
MR. CASEY H ANSON (EXECUTIVE DIRECTOR)
(580) 925-8804
Entity
Organization
Contact information
Practice address
220 SOUTH 5TH ST, NOBLE, OK 73068
(580) 925-3286
(580) 925-3924
Mailing address
PO BOX 358, 527 WEST THIRD STREET, KONAWA, OK 74849
(580) 925-3286
(580) 925-3924
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
03/19/2008
Last updated
04/20/2008
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