OrganizationActive
Jackie Fields Foundation
NPI 1578865317 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Muskogee, OK
Provider details
- NPI number
- 1578865317
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jackie Stanford, Ceo(918) 913-6017
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
2303 Pickens
Muskogee, OK 74402
Phone: (918) 913-6017
Approximate (ZIP-level) locationGet directions
Mailing address
Pob 1810 2303 Pickens
Muskigee, OK 74402
Registry dates
- Enumerated
- 2010-11-30
- Last updated
- 2010-11-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.