Organization
UHS OKLAHOMA CTIY, LLC
Active
Other names
Cedar Ridge Adolescent RTC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A. HOLTER RN (CEO)
40560561111
Entity
Organization
Contact information
Practice address
6501 NE 50TH ST, OKLAHOMA CITY, OK 73141-9118
(405) 605-6111
(405) 424-0457
Mailing address
6501 NE 50TH ST, OKLAHOMA CITY, OK 73141-9118
(405) 605-6111
(405) 424-0457
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
K8500000368
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200085660E
—
OK
Enumeration date
04/26/2010
Last updated
04/26/2010
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