Provider Demographics
NPI:1609116078
Name:CLEVELAND COUNTY SHERIFFS OFFICE
Entity type:Organization
Organization Name:CLEVELAND COUNTY SHERIFFS OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF JAIL DIVERSION
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LADC, BHCM3
Authorized Official - Phone:405-701-8163
Mailing Address - Street 1:128 S PETERS AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6034
Mailing Address - Country:US
Mailing Address - Phone:405-701-8163
Mailing Address - Fax:405-310-3739
Practice Address - Street 1:128 S PETERS AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6034
Practice Address - Country:US
Practice Address - Phone:405-701-8163
Practice Address - Fax:405-310-3739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health