Provider Demographics
NPI:1124711619
Name:GOODLAND INC
Entity type:Organization
Organization Name:GOODLAND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-326-7568
Mailing Address - Street 1:1216 N 4200 RD
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-8510
Mailing Address - Country:US
Mailing Address - Phone:580-326-7568
Mailing Address - Fax:
Practice Address - Street 1:1216 N 4200 RD
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-8510
Practice Address - Country:US
Practice Address - Phone:580-326-7568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care