Provider Demographics
NPI:1699420869
Name:CLEEKHAM EMPOWER ACADEMY LLC
Entity type:Organization
Organization Name:CLEEKHAM EMPOWER ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TEAH
Authorized Official - Middle Name:LISA LYNN
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-970-6225
Mailing Address - Street 1:7106 E 151ST ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-4137
Mailing Address - Country:US
Mailing Address - Phone:918-970-6225
Mailing Address - Fax:
Practice Address - Street 1:7106 E 151ST ST S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-4137
Practice Address - Country:US
Practice Address - Phone:918-970-6225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN PLAINS TREATMENT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility