Organization
CREOKS MENTAL HEALTH SERVICES, INC
Active
Other names
CREOKS Behavioral Health Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT M. BLACK LPC (CEO)
(918) 756-9411
Entity
Organization
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-0242
(918) 485-0204
Mailing address
4103 S YALE AVE STE B, TULSA, OK 74135-6002
(918) 382-7300
(918) 382-7302
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100734620
OK
Other
Enumeration date
11/08/2010
Last updated
10/15/2019
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