PRODIGY FOUNDATION

TAHLEQUAH, OK
NPI1700928603
Entity TypeOrganization
Authorized ContactBARRY B. AVERETT
Office Manager
918-456-8399
Organization Subpart ?No
Primary Taxonomy251S00000X Community/Behavioral Health
Enumeration Date2007-02-14
Last Update Date2020-08-22
Business Address
PRODIGY FOUNDATION
1024 S MUSKOGEE AVE
TAHLEQUAH, OK 74464-4734
Phone number: 918-456-8399
Mailing Address
PRODIGY FOUNDATION
1024 S MUSKOGEE AVE
TAHLEQUAH, OK 74464-4734
Phone number: 918-456-8399
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