Organization
CHICKASAW NATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD CRAWFORD (DIRECTOR COMMUNITY BASED SERVICES-)
(580) 559-0810
Entity
Organization
Contact information
Practice address
101 ARROWHEAD DR, PAULS VALLEY, OK 73075-5301
(405) 331-2300
(405) 331-2302
Mailing address
1400 HOPPE BLVD STE 2, ADA, OK 74820-2313
(580) 559-0810
(580) 272-5734
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
171M00000X
OK
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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