Provider Demographics
NPI:1386989242
Name:CENTRAL OK COMMUNITY MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:CENTRAL OK COMMUNITY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-360-5100
Mailing Address - Street 1:909 ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-5229
Mailing Address - Country:US
Mailing Address - Phone:405-360-5100
Mailing Address - Fax:405-573-3966
Practice Address - Street 1:909 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5229
Practice Address - Country:US
Practice Address - Phone:405-360-5100
Practice Address - Fax:405-573-3966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPT. OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health