Organization
GREEN COUNTRY BEHAVIORAL HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL NELSON (COMPLIANCE OFFICER)
(918) 913-3604
Entity
Organization
Contact information
Practice address
1320 N MILL ST, MUSKOGEE, OK 74401-2009
(918) 682-8407
(918) 682-4636
Mailing address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 682-8407
(918) 682-4636
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100734050
ODMHSAS
OK
05
—
100734050
—
OK
Enumeration date
10/22/2021
Last updated
10/22/2021
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