Basic Information
| Provider Information | |||||||||
| NPI: | 1104129311 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTERN PLAINS YOUTH & FAMILY SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1213 W HANKS TRAIL | ||||||||
| Address2: | |||||||||
| City: | WOODWARD | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802545322 | ||||||||
| FaxNumber: | 5802545335 | ||||||||
| Practice Location | |||||||||
| Address1: | 7TH & OKLAHOMA | ||||||||
| Address2: | STE 8B | ||||||||
| City: | LAVERNE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802545322 | ||||||||
| FaxNumber: | 5802545335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2010 | ||||||||
| LastUpdateDate: | 12/09/2010 | ||||||||
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| AuthorizedOfficialLastName: | EVANS | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5802563157 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.