Organization
CROSSWAY COUNSLING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY GILBERT (OFFICE ASSISTANT)
(580) 371-9933
Entity
Organization
Contact information
Practice address
9420 SOUTH RED MAN RD., RAVIA, OK 73455
(580) 371-7328
Mailing address
9420 SOUTH RED MAN RD., RAVIA, OK 73455
(580) 371-7328
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
MEDICADE AND MEDICARE
—
Enumeration date
12/04/2014
Last updated
12/04/2014
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