Organization
TENKILLER BEHAVIORAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAVETTA MCINTOSH (CEO OWNER)
(918) 457-4221
Entity
Organization
Contact information
Practice address
27753 S WELLING RD, WELLING, OK 74471-2202
(918) 457-4999
(918) 457-4104
Mailing address
27753 S WELLING RD, WELLING, OK 74471-2202
(918) 457-4999
(918) 457-4104
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708280C
—
OK
Enumeration date
11/15/2006
Last updated
11/09/2009
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