Organization
ABSENTEE SHAWNEE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN CROSS MDIV, LADC (EXECUTIVE DIRECTOR)
(405) 672-3033
Entity
Organization
Contact information
Practice address
1301 SE 59TH ST, OKLAHOMA CITY, OK 73129-7307
(405) 672-3033
(405) 672-8371
Mailing address
1301 SE 59TH STREET, OKLAHOMA CITY, OK 73129-7307
(405) 672-3033
(405) 672-8371
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
ODMHSAS
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376775775
—
OK
05
—
1417289356
—
OK
05
—
1538363320
—
OK
05
—
1639409626
—
OK
05
—
1750682001
—
OK
Enumeration date
07/17/2007
Last updated
01/24/2012
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