Provider Demographics
NPI:1487298709
Name:GOODWILL INDUSTRIES OF SOUTHWEST OKLAHOMA AND NORTH TEXAS INC
Entity type:Organization
Organization Name:GOODWILL INDUSTRIES OF SOUTHWEST OKLAHOMA AND NORTH TEXAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF PROGRAM SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:SKULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-248-9313
Mailing Address - Street 1:923 NW HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-1335
Mailing Address - Country:US
Mailing Address - Phone:580-248-9313
Mailing Address - Fax:
Practice Address - Street 1:923 NW HILLTOP DR
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-1335
Practice Address - Country:US
Practice Address - Phone:580-248-9313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care