Basic Information
| Provider Information | |||||||||
| NPI: | 1699970616 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BRIGGS FAMILY AND YOUTH ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1211 N SHARTEL AVE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731032400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4055218635 | ||||||||
| FaxNumber: | 4055218652 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 N SHARTEL AVE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731032400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4055218635 | ||||||||
| FaxNumber: | 4055218652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2007 | ||||||||
| LastUpdateDate: | 06/14/2010 | ||||||||
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| AuthorizedOfficialLastName: | BRIGGS | ||||||||
| AuthorizedOfficialFirstName: | JANICE | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4055218635 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | M.S. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 251B00000X | OK | N | Agencies | Case Management | 251B00000X | TX | N | Agencies | Case Management | 251S00000X | TX | N | Agencies | Community/Behavioral Health | 251S00000X | OK | Y | Agencies | Community/Behavioral Health |
No ID Information.