Organization
JACK BROWN TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN DRY (DIRECTOR)
(918) 453-5519
Entity
Organization
Contact information
Practice address
17091 S MUSKOGEE AVE, TAHLEQUAH, OK 74465
(918) 453-5501
(918) 458-0499
Mailing address
PO BOX 397, PARK HILL, OK 74451-0397
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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