Organization
LOGAN COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERRYE NICOLE CLARK (FSP-FAMILY SUPPORT PROVIDER)
(405) 282-5524
Entity
Organization
Contact information
Practice address
4710 S. DIVISION STREET, GUTHRIE, OK 73044-6506
(405) 282-5524
(405) 282-4652
Mailing address
4710 S. DIVISION STREET, GUTHRIE, OK 73044-6506
(405) 282-5524
(405) 282-4652
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
22322
OK
Other
Enumeration date
12/21/2010
Last updated
12/21/2010
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