# MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699811802
- **Authorized official:** ROBERT E LEE LCSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (580) 223-5070

## Contact information

- **Practice address:** 2530 S COMMERCE, BLDG A, ARDMORE, OK 73401-5519
- **Practice address phone:** (580) 223-5070
- **Practice address fax:** (580) 223-5617
- **Mailing address:** PO BOX 189, ARDMORE, OK 73402-0189
- **Mailing address phone:** (580) 223-5070
- **Mailing address fax:** (580) 223-5617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 12/31/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100728830 O | — | OK |