Provider Demographics
NPI:1427151521
Name:OKLAHOMA COUNTY CRISIS INTERVENTION CENTER
Entity type:Organization
Organization Name:OKLAHOMA COUNTY CRISIS INTERVENTION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC/MH
Authorized Official - Phone:405-795-6893
Mailing Address - Street 1:2000 N CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6016
Mailing Address - Country:US
Mailing Address - Phone:405-248-9089
Mailing Address - Fax:
Practice Address - Street 1:2625 GENERAL PERSHING
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-3277
Practice Address - Country:US
Practice Address - Phone:405-942-2300
Practice Address - Fax:405-942-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK700522089Medicare ID - Type UnspecifiedPROVIDER #