Organization
MODOC NATION BEHAVIORAL HEALTH
Active
Organization
MODOC NATION BEHAVIORAL HEALTH
Active
Parent organization
MODOC NATION BEHAVIORAL HEALTH
Other names
Lost River, Lost River Treatment Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MODOC NATION BEHAVIORAL HEALTH
Authorized official
LACI BARTON APRN-CNP (DIRECTOR OF OPERATIONS)
(918) 303-5433
Entity
Organization
Contact information
Practice address
10025 S 705 RD, WYANDOTTE, OK 74370-9507
(918) 303-5433
Mailing address
22 N EIGHT TRIBES TRL, MIAMI, OK 74354-1011
(918) 542-1190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
06/25/2026
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