Organization
COMMUNITY NETWORK COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI BASS (ADMINISTRATOR)
(702) 591-3055
Entity
Organization
Contact information
Practice address
11601 E WILSHIRE BLVD, SPENCER, OK 73084-6718
(702) 591-3055
Mailing address
11601 E WILSHIRE BLVD, SPENCER, OK 73084-6718
(702) 591-3055
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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