Provider First Line Business Practice Location Address: 
6655 S YALE AVE
    Provider Second Line Business Practice Location Address: 
LAUREATE PSYCHIATRIC CLINIC AND HOSPTIAL
    Provider Business Practice Location Address City Name: 
TULSA
    Provider Business Practice Location Address State Name: 
OK
    Provider Business Practice Location Address Postal Code: 
74136-3326
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
918-481-4000
    Provider Business Practice Location Address Fax Number: 
918-491-5740
    Provider Enumeration Date: 
03/24/2006