Organization
SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF OKLAHOMA, INC.
Active
Other names
SAFY OF OKLAHOMA - LAWTON
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC BLOOMINGDALE M.S. (VICE PRESIDENT OF OPERATIONS)
(817) 789-2611
Entity
Organization
Contact information
Practice address
1320 NW HOMESTEAD DR, SUITE G, LAWTON, OK 73505-5243
(580) 536-9129
(580) 536-9132
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100710730A
—
OK
05
—
100710730B
—
OK
05
—
100710730C
—
OK
Enumeration date
11/28/2006
Last updated
02/07/2014
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