Provider Demographics
NPI:1316492242
Name:PATTON BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:PATTON BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:MHR,LPC
Authorized Official - Phone:405-534-8355
Mailing Address - Street 1:2410 W MEMORIAL RD
Mailing Address - Street 2:101
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-8047
Mailing Address - Country:US
Mailing Address - Phone:405-534-8355
Mailing Address - Fax:
Practice Address - Street 1:2410 W MEMORIAL RD
Practice Address - Street 2:101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-8047
Practice Address - Country:US
Practice Address - Phone:405-534-8355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-21
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5681251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health