Organization
PHOENIX GATE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVORA P. SENSIBAUGH BSW (SOCIAL WORKER)
(918) 423-9400
Entity
Organization
Contact information
Practice address
32 E CHEROKEE AVE, SUITE 104, MCALESTER, OK 74501-5323
(918) 423-9400
(918) 423-9400
Mailing address
32 E CHEROKEE AVE, SUITE 104, MCALESTER, OK 74501-5323
(918) 423-9400
(918) 423-9400
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/19/2010
Last updated
01/19/2010
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