Organization
EAGLE RIDGE FAMILY TREATMENT CENTER
Active
Parent organization
EAGLE RIDGE INSTITUTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGLE RIDGE INSTITUTE
Authorized official
MS. PATRICE DARLENE STALEY (PRIMARY COUNSELOR)
(405) 282-8272
Entity
Organization
Contact information
Practice address
1916 E PERKINS AVE, 1916 E PERKINS, GUTHRIE, OK 73044-5804
(405) 282-8272
Mailing address
PO BOX 1182, GUTHRIE, OK 73044-1182
(405) 282-8272
(405) 282-3305
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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