SOUTHEASTERN OKLAHOMA FAMILY SERVICES (NPI# 1801133236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801133236 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN OKLAHOMA FAMILY SERVICES |
| Practice Address |
1501 N Washington Ave Durant OK 74701-2127 |
| Mailing Address |
Po Box 1710 Kingston OK 73439-1710 |
| Practice Telephone | 5809313008 |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2017-06-08 |
| Authorized Official Name | VIRGINIA RAGAN (CEO) |
| Authorized Official Telephone | 5809313008 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164725305 | Southeastern Oklahoma Family Services | Community/Behavioral Health | 47 E Foley St, Eufaula, OK 74432-3019 | 2010-12-09 |
| 1285978437 | Southeastern Oklahoma Family Services | Community/Behavioral Health | 705 W 13th St, Atoka, OK 74525-3712 | 2012-11-11 |
| Street Address |
1501 N WASHINGTON AVE |
| City | DURANT |
| State | OK |
| Zip Code | 74701-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366928988 | Shelby Berry | Case Manager/Care Coordinator | 1501 N Washington Ave, Durant, OK 74701-2127 | 2018-07-17 |
| 1255860409 | Adele Nicole Rister | Case Manager/Care Coordinator | 1501 N Washington Ave, Durant, OK 74701 | 2017-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801321070 | April Brock | Community Based Residential Treatment Facility, Mental Illness | 106 12th Ave Ne, Miami, OK 74354-3373 | 2017-04-25 |
| 1114321486 | Cedric Glenn | Community Based Residential Treatment Facility, Mental Illness | 1721 E 72nd St, 1803, Tulsa, OK 74136-5372 | 2014-10-15 |
| 1083058523 | Mongo Allen | Community Based Residential Treatment Facility, Mental Illness | 829 Nw 142nd St, Edmond, OK 73013-1962 | 2013-04-27 |
| 1043595879 | Oaktree Counseling Services | Community Based Residential Treatment Facility, Mental Illness | 2104 Nw Britni Cir, Lawton, OK 73505-3121 | 2011-10-12 |
| 1790089829 | Southern Oklahoma Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 5862 Us Hwy 70, Mead, OK 73449 | 2011-01-04 |
| 1285966747 | Dr. C Professional Services, Pllc | Community Based Residential Treatment Facility, Mental Illness | 7109 S Kentucky Ave, Oklahoma City, OK 73159-3427 | 2010-02-09 |
| 1881921898 | Sequoyah Residential Mental Health Facility, Inc | Community Based Residential Treatment Facility, Mental Illness | 103 N Wheeler Ave, Sallisaw, OK 74955-4617 | 2009-11-11 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| 1558570309 | Meadow Brook Residential Care Facility | Community Based Residential Treatment Facility, Mental Illness | 1000 Meadow Lane, Howe, OK 74940 | 2007-05-21 |
| 1568580108 | Transition House, Inc. | Community Based Residential Treatment Facility, Mental Illness | 700 Asp Ave, Suite 2, Norman, OK 73069-4900 | 2007-03-26 |
| Find all providers with the same taxonomy | ||||
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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.