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Organization
COMMUNITY YOUTH SERVICES OF SOUTHERN OKLAHOMA, INC.
Active
Organization
COMMUNITY YOUTH SERVICES OF SOUTHERN OKLAHOMA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLYN DAWN WELDON GARY (EXECUTIVE DIRECTOR)
(580) 226-1838
Entity
Organization
Contact information
Practice address
830 PARK ST SE, ARDMORE, OK 73401-8364
(580) 226-1838
(580) 223-7856
Mailing address
830 PARK ST SE, ARDMORE, OK 73401-8364
(580) 226-1838
(580) 223-7856
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100709510A
—
OK
Enumeration date
03/14/2007
Last updated
07/30/2024
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