Organization
EAGLE RIDGE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY M VAUGHN LPC (ASSOCIATE EXECUTIVE DIRECTOR)
(405) 282-5283
Entity
Organization
Contact information
Practice address
1515 W CHICKASAW, SALLISAW, OK 74955
(918) 775-4646
(405) 282-3038
Mailing address
601 NE 63 ST, OKLAHOMA CITY, OK 73105
(405) 282-5283
(405) 282-3038
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/17/2009
Last updated
07/17/2009
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