JACK BROWN CENTER (NPI# 1437396850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437396850 |
| Entity Type | Organization |
| Organization Name | JACK BROWN CENTER |
| Other Organization Name | CHEROKEE NATION |
| Practice Address |
17091 South Muskogee Avenue Tahlequah OK 74465 |
| Mailing Address |
21141 S Forrest Dr Tahlequah OK 74464-7404 |
| Practice Telephone | 9184535500 |
| Mailing Telephone | 9182070810 |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |
| Authorized Official Name | MR. DARREN D. DRY (DIRECTOR) |
| Authorized Official Telephone | 1918455520 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 3261 | OK | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Cherokee nation | Other Name - Individual/Organization |
| Street Address |
17091 SOUTH MUSKOGEE AVENUE |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386914646 | Debra Lee Johnson | Case Manager/Care Coordinator | 17091 South Muskogee Avenue, Cherokee Nation, Tahlequah, OK 74465-0948 | 2012-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780939223 | Jack Brown Treatment Center | Substance Abuse Rehabilitation Facility | 17091 S Muskogee Ave, Tahlequah, OK 74465 | 2012-07-20 |
| 1821287962 | Cornerstone Home Health Care | Home Health | 1699 West Fourth Street, Tahlequah, OK 74465 | 2007-10-15 |
| 1144414764 | Adam Carroll Cothran | Social Worker | 17675 S. Muskogee Ave., Tahlequah, OK 74465 | 2007-08-28 |
| 1194895441 | Eeg Corporation | Psychiatry & Neurology | 1400 E Downing, Tahlequah, OK 74465 | 2006-11-08 |
| 1700951050 | Harold Earl Goldman | Pediatrics | 1400 E Downing, Tahlequah, OK 74465 | 2006-11-22 |
| 1609123892 | Sonya Davidson | Counselor | 17091 S Muskogee Ave, Tahlequah, OK 74465-0000 | 2012-08-07 |
| 1508987959 | State of Oklahoma; Dba:bill Willis Community Mental Health Center | Clinic/Center | 1400 S. Hensley Dr, Tahlequah, OK 74465-0558 | 2007-04-03 |
| 1770937229 | Talking Leaves Job Corps | Psychologist | 5700 Bald Hill Road, Tahlequah, OK 74465-1066 | 2016-04-21 |
| 1689909574 | Lori Elizabeth Medina | Counselor | 17091 S. Muskogee, Tahlequah, OK 74465-4405 | 2009-10-09 |
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790301893 | Second Chance Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 4238 Ne 1st St, Pryor, OK 74361-9614 | 2020-06-24 |
| 1912551805 | Estelle Hawkins | Substance Abuse Rehabilitation Facility | 21227 N County Road 3350, Wynnewood, OK 73098-9356 | 2019-07-29 |
| 1902359391 | Ryan Fitzpatrick | Substance Abuse Rehabilitation Facility | 7138 S Canton Ave, Tulsa, OK 74136-6303 | 2016-08-02 |
| 1609223866 | Seven Ponds Energy LLC Dba Seven Ponds Residential Treatment | Substance Abuse Rehabilitation Facility | 1760 Blevins Rd., Bennington, OK 74723 | 2016-05-18 |
| 1679938534 | Claudia Antoinette Parker | Substance Abuse Rehabilitation Facility | 301 Pointe Parkway Blvd Apt 706, Yukon, OK 73099-0641 | 2015-12-20 |
| 1184089328 | Door 2 Ur Future | Substance Abuse Rehabilitation Facility | 1050 E 61st St Apt 89, Tulsa, OK 74136-1397 | 2015-12-15 |
| 1144627233 | Denise Evyonne Engram | Substance Abuse Rehabilitation Facility | 4723 S Ash Dr, Broken Arrow, OK 74011-3464 | 2014-12-04 |
| 1093127979 | Kimberly Ann Kelly-lorenz | Substance Abuse Rehabilitation Facility | 163 Mohawk Dr, Canadian, OK 74425-9747 | 2014-05-27 |
| 1558783589 | Vizown LLC | Substance Abuse Rehabilitation Facility | 24962 Okay Rd, Tecumseh, OK 74873-6504 | 2014-01-10 |
| 1104256684 | Robert Watson | Substance Abuse Rehabilitation Facility | 111 W 5th St Ste 600, Tulsa, OK 74103-4260 | 2013-11-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.