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Organization
PROVIDENCE SERVICE CORPORATION OF OKLAHOMA
Active
Organization
PROVIDENCE SERVICE CORPORATION OF OKLAHOMA
Active
Other names
Providence of Oklahom
Organization subpart
No
Provider details
NPI number
Authorized official
BREEANN MARIE HOERNING (AR AND BILLING MANAGER)
(520) 747-6600
Entity
Organization
Contact information
Practice address
134 N 12TH AVE, DURANT, OK 74701-4718
(580) 924-6363
(580) 924-0379
Mailing address
620 N CRAYCROFT RD, TUCSON, AZ 85711-1448
(520) 747-6600
(520) 747-6613
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
08/22/2020
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