Provider Demographics
NPI:1689482945
Name:COMMUNITY OPIOID PREVENTION EMPOWERMENT
Entity type:Organization
Organization Name:COMMUNITY OPIOID PREVENTION EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREVENTION SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-340-1672
Mailing Address - Street 1:2204 SW 137TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5731
Mailing Address - Country:US
Mailing Address - Phone:580-340-1672
Mailing Address - Fax:
Practice Address - Street 1:2424 W WRANGLER BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1915
Practice Address - Country:US
Practice Address - Phone:580-340-1672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEMINOLE NATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health