Organization
YOUTH SERVICES OF TULSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG HENDERSON LCSW (DIRECTOR)
91895820061
Entity
Organization
Contact information
Practice address
311 S MADISON AVE, TULSA, OK 74120-3208
(918) 582-0061
Mailing address
311 S MADISON AVE, TULSA, OK 74120-3208
(918) 582-0061
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100710510E
—
OK
Enumeration date
12/08/2006
Last updated
07/17/2012
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