Organization
NORTHWEST DOMESTIC CRISIS SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FOCKLER (EXECUTIVE DIRECTOR)
(580) 256-1215
Entity
Organization
Contact information
Practice address
1330 OKLAHOMA BLVD., ALVA,, OK 73717
(580) 327-6648
(580) 327-6980
Mailing address
1323 KANSAS ST., WOODWARD, OK 73801
(580) 256-1215
(580) 256-1245
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
101YP2500X
OK
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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