Provider Demographics
NPI:1639562168
Name:BEHAVIORAL HEALTH UNLIMITED LLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH UNLIMITED LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-235-6709
Mailing Address - Street 1:1450 CARSON RD
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-7080
Mailing Address - Country:US
Mailing Address - Phone:918-235-6709
Mailing Address - Fax:918-235-6713
Practice Address - Street 1:1450 CARSON ROAD
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-7080
Practice Address - Country:US
Practice Address - Phone:918-235-6709
Practice Address - Fax:918-235-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherEIN