Organization
THUNDERBIRD CLUBHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA SANFORD LCSW (EXECUTIVE DIRECTOR)
(405) 321-7331
Entity
Organization
Contact information
Practice address
1251 TRIAD VILLAGE DR, NORMAN, OK 73071-2967
(405) 321-7331
(405) 364-6058
Mailing address
1251 TRIAD VILLAGE DR, NORMAN, OK 73071-2967
(405) 321-7331
(405) 364-6058
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200268830A
—
OK
Enumeration date
11/09/2011
Last updated
11/09/2011
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