Basic Information
| Provider Information | |||||||||
| NPI: | 1295852812 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT FRANCIS COMMUNITY SERVICES IN OKLAHOMA, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 509 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674012353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858250541 | ||||||||
| FaxNumber: | 7858250062 | ||||||||
| Practice Location | |||||||||
| Address1: | 7320 S YALE AVENUE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184880163 | ||||||||
| FaxNumber: | 9184881583 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| AuthorizedOfficialLastName: | PATRICK | ||||||||
| AuthorizedOfficialFirstName: | KRISTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF ACCOUNTING SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 7858250541 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 4634 | OK | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 251B00000X | 767-003 | KS | Y | Agencies | Case Management |
ID Information
| ID | Type | State | Issuer | Description | 200219080B | 05 | OK | MEDICAID | 100004620E | 05 | KS | MEDICAID |