Organization
JIM WALLACE & ASSOCIATES INC
Active
Other names
The Jetty Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA G RUE-WALLACE (CEO)
(405) 665-4385
Entity
Organization
Contact information
Practice address
1610 W JACKSON ST, HUGO, OK 74743-5653
(405) 665-4385
(405) 665-6396
Mailing address
202 S WASHITA AVE, WYNNEWOOD, OK 73098-7820
(405) 665-4385
(405) 665-6396
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100749080B
—
OK
Enumeration date
02/23/2007
Last updated
05/31/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us