Organization
RIVERSIDE BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREY MCKELLAR LSW (CLININCAL AND OUTPATIENT DIRECTOR)
(918) 855-2031
Entity
Organization
Contact information
Practice address
4618 S 31ST WEST AVE, TULSA, OK 74107-7532
(662) 419-9786
Mailing address
4618 S 31ST WEST AVE, TULSA, OK 74107-7532
(662) 419-9786
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
801081083
MS
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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