Organization
GRAND GATEWAY ECONOMIC DEVELOPMENT ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERRIN CLOCKER BSBA (FINANCIAL OFFICER)
(918) 783-5761
Entity
Organization
Contact information
Practice address
333 SOUTH OAK STREET, BIG CABIN, OK 74332-0502
(918) 783-5761
(918) 783-5829
Mailing address
PO BOX B, BIG CABIN, OK 74332-0502
(918) 783-5761
(918) 783-5798
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
100679410D
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100679410D
—
OK
Enumeration date
11/11/2008
Last updated
11/11/2008
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