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Organization

EDWIN FAIR COMMUNITY MENTAL HEALTH CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEOFFREY H COWAN LPC (EXECUTIVE DIRECTOR)
(580) 762-7561
Entity
Organization

Contact information

Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
(580) 762-2576
Mailing address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
(580) 762-2576

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
03/28/2007
Last updated
08/22/2020
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