Organization
STATE OF OKLAHOMA
Active
Organization
STATE OF OKLAHOMA
Active
Other names
Tulsa Center for Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN NICKELSON (INTERIM EXECUTIVE DIRECTOR)
(580) 256-8615
Entity
Organization
Contact information
Practice address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2140
(918) 712-7164
Mailing address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2140
(918) 293-2195
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100707460
—
OK
Enumeration date
07/15/2006
Last updated
09/06/2023
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