Eagle Ridge

NPI #1326202003 in Guthrie, Oklahoma

Provider Information

NPI Number: 1326202003
Entity Type: Organization
Organization Name: Eagle Ridge
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Jul 11, 2008
Last Updated: Apr 12, 2018

Practice Location

Address: 1916 E PERKINS AVE
City: Guthrie
State: Oklahoma
ZIP Code: 73044-5804
Phone: (405) 282-8262

Authorized Official

Name: CYNTHIA JANE WILLIS
Title: PERSONNEL & COMPLIANCE OFFICER
Phone: (405) 858-2821

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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