Organization
CREOKS MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TABITHA TALBOT (GOHEALTH HELPDESK MANAGER)
(918) 382-7300
Entity
Organization
Contact information
Practice address
504 N BROADWAY AVE, SHAWNEE, OK 74801-6927
(405) 275-1844
(405) 275-1124
Mailing address
323 W 6TH ST, OKMULGEE, OK 74447-5019
(918) 756-9411
(918) 756-2126
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
561
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734620
—
OK
Enumeration date
02/10/2012
Last updated
10/15/2019
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