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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