Provider Demographics
NPI:1386939767
Name:CATHOLIC CHARITIES
Entity type:Organization
Organization Name:CATHOLIC CHARITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:580-237-7352
Mailing Address - Street 1:528 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-3842
Mailing Address - Country:US
Mailing Address - Phone:580-237-7352
Mailing Address - Fax:
Practice Address - Street 1:528 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3842
Practice Address - Country:US
Practice Address - Phone:580-237-2542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management