Provider Demographics
NPI:1053562579
Name:DOMESTIC VIOLENCE INTERVENTION SERVICES, (DVIS)/CALL RAPE, INC.
Entity type:Organization
Organization Name:DOMESTIC VIOLENCE INTERVENTION SERVICES, (DVIS)/CALL RAPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILDREN'S PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAKEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:918-585-3170
Mailing Address - Street 1:4300 S. HARVARD AVE.
Mailing Address - Street 2:100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135
Mailing Address - Country:US
Mailing Address - Phone:918-585-3170
Mailing Address - Fax:918-584-1835
Practice Address - Street 1:4300 S. HARVARD AVE.
Practice Address - Street 2:100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135
Practice Address - Country:US
Practice Address - Phone:918-585-3170
Practice Address - Fax:918-584-1835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty