Provider Demographics
NPI:1174876312
Name:YCO OF OKC, INC. D/B/A YOUTHCARE OF OKLAHOMA, INC.
Entity type:Organization
Organization Name:YCO OF OKC, INC. D/B/A YOUTHCARE OF OKLAHOMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBATO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MPH
Authorized Official - Phone:405-222-8167
Mailing Address - Street 1:222 E SHERIDAN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4233
Mailing Address - Country:US
Mailing Address - Phone:405-200-0124
Mailing Address - Fax:405-270-0543
Practice Address - Street 1:222 E SHERIDAN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4233
Practice Address - Country:US
Practice Address - Phone:405-200-0124
Practice Address - Fax:405-270-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility