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Organization
WHITE HORSE RANCH OUTPATIENT, LLC
Active
Organization
WHITE HORSE RANCH OUTPATIENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE RENEE SMITH LPC, LADC (EXECUTIVE DIRECTOR)
(580) 571-1272
Entity
Organization
Contact information
Practice address
40803 S COUNTY ROAD 213, 1601 WILKIE ROAD, MOORELAND, OK 73852-9131
(580) 994-5649
(580) 994-5972
Mailing address
40803 S COUNTY ROAD 213, 1601 WILKIE ROAD, MOORELAND, OK 73852-9131
(580) 994-5649
(580) 994-5972
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4974
OK
251S00000X
Community/Behavioral Health Agency
839
OK
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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