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Organization

TENKILLER BEHAVIORAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTA MICHELLE ROACH LPC (ADMINISTRATOR)
(918) 797-7786
Entity
Organization

Contact information

Practice address
110 W MAPLE ST, STILWELL, OK 74960-3100
(918) 797-7786
(918) 696-8679
Mailing address
27753 S WELLING RD, WELLING, OK 74471-2202
(918) 797-7786
(918) 457-4104

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100708280
OK
Enumeration date
02/12/2014
Last updated
02/12/2014
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