1447260534 NPI number — YCO CLINTON, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447260534 NPI number — YCO CLINTON, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YCO CLINTON, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
YOUTHCARE OF OKLAHOMA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447260534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73143-5207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-926-6552
Provider Business Mailing Address Fax Number:
405-632-0038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 S 10TH ST
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73601-5230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-926-6552
Provider Business Practice Location Address Fax Number:
580-323-6152
Provider Enumeration Date:
08/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LOBATO
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
866-926-6552

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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