Organization
NORTHEASTERN HEALTH SYSTEM
Active
Organization
NORTHEASTERN HEALTH SYSTEM
Active
Other names
TAHLEQUAH HOSPITAL AUTHORITY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN WOODLIFF (CEO)
(918) 456-0641
Entity
Organization
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
1400 E DOWNING ST, PO BOX 1008, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
2178
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700680A
—
OK
Enumeration date
12/19/2006
Last updated
04/06/2026
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