Organization
WAYNOKA MENTAL HEALTH AUTHORITY
Active
Other names
Northwest Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
CLARISSA M FIFIELD LCSW PROVISIONAL (COUNSELOR)
(580) 824-0674
Entity
Organization
Contact information
Practice address
1095 NICKERSON ST, WAYNOKA, OK 73860-1252
(580) 824-0674
(580) 824-0676
Mailing address
PO BOX 135, WAYNOKA, OK 73860-0135
(580) 824-0674
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
5433-P
OK
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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