Organization
FAMILY AND YOUTH INTERVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BAINES (PROGRAM DIRECTOR)
(918) 852-4695
Entity
Organization
Contact information
Practice address
5555 S LEWIS AVE, TULSA, OK 74105-7104
(918) 779-4556
(918) 895-6917
Mailing address
2624 N QUINCY AVE, TULSA, OK 74106-2604
(918) 949-1404
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OK
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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