Basic Information
| Provider Information | |||||||||
| NPI: | 1780981530 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POSITIVE SOLUTIONS YOUTH & FAMILY SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5724 SE 86TH | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | N/A | ||||||||
| PostalCode: | 73135 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 4058645724 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5724 SE 86TH ST | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731356025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058635724 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2011 | ||||||||
| LastUpdateDate: | 03/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | PATTERSON | ||||||||
| AuthorizedOfficialFirstName: | LARRENDA | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4058635724 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MS,LPC,LADC(CAND) | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | OK | N | Agencies | Case Management | 251S00000X | OK | Y | Agencies | Community/Behavioral Health |
No ID Information.