Organization
GREEN COUNTRY BEHAVIORAL HEALTH SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB HISELEY CMII, PRSS, WELLNESS (CASE MANAGER)
(918) 323-6324
Entity
Organization
Contact information
Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 323-6324
Mailing address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 323-6324
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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