Organization
MENTAL HEALTH SERVICE OF SOUTHERN OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUNA LIA (ADMINISTRATIVE ASSISTANT)
(580) 319-7305
Entity
Organization
Contact information
Practice address
2425 W UNIVERSITY BLVD, DURANT, OK 74701-2942
(580) 924-7330
(580) 924-2739
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 319-7305
(580) 319-7328
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830
—
OK
Enumeration date
02/28/2020
Last updated
02/28/2020
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