Organization
LIFT COMMUNITY ACTION AGENCY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA PORTER (EXECUTIVE DIRECTOR)
(580) 326-3351
Entity
Organization
Contact information
Practice address
1005 S 5TH ST BLDG 4, HUGO, OK 74743-8013
(803) 263-3515
Mailing address
209 N 4TH ST, HUGO, OK 74743-3809
(580) 326-3351
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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