Provider Demographics
NPI:1487098331
Name:THOMAS YOUTH & FAMILY SERVICE
Entity type:Organization
Organization Name:THOMAS YOUTH & FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BHRS
Authorized Official - Prefix:
Authorized Official - First Name:GERREL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-822-3452
Mailing Address - Street 1:PO BOX 13362
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73113-1362
Mailing Address - Country:US
Mailing Address - Phone:405-822-3452
Mailing Address - Fax:
Practice Address - Street 1:2237 NW 117TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-7804
Practice Address - Country:US
Practice Address - Phone:405-822-3452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health