Organization
DOMESTIC VIOLENCE INTERVENTION SERVICES/ CALL RAPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY BOOTH MSW, LSW (EXECUTIVE DIRECTOR)
(918) 585-3163
Entity
Organization
Contact information
Practice address
4300 S HARVARD AVE, SUITE 100, TULSA, OK 74135-2619
(918) 585-3163
(918) 584-1835
Mailing address
1607 N HARTFORD AVE, TULSA, OK 74106-4304
(918) 584-7500
(918) 585-2676
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
7243
OK
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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