Provider Demographics
NPI:1972631349
Name:SOUTHWEST YOUTH AND FAMILY SERVICES, INC.
Entity type:Organization
Organization Name:SOUTHWEST YOUTH AND FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-222-5437
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-0829
Mailing Address - Country:US
Mailing Address - Phone:405-222-5437
Mailing Address - Fax:405-222-5441
Practice Address - Street 1:198 E. ALMAR DR.
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018
Practice Address - Country:US
Practice Address - Phone:405-222-5437
Practice Address - Fax:405-222-5441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK909OtherODMHSAS