Organization
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM
Active
Organization
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KISTLER (CEO)
(918) 492-8200
Entity
Organization
Contact information
Practice address
1013 E 66TH PL, TULSA, OK 74136-3701
(918) 293-2500
(918) 492-2075
Mailing address
1013 E 66TH PL, TULSA, OK 74136-3701
(918) 293-2500
(918) 492-2075
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
4073
OK
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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