Organization
STATE OF OKLAHOMA DEPT. OF HUMAN SERVICES
Active
Other names
Souther Oklahoma Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM E JOHNSON (PROGRAMS MANAGER)
(405) 521-3565
Entity
Organization
Contact information
Practice address
RT. 1 BOX 44-A, PAULS VALLEY, OK 73075
(405) 238-6401
Mailing address
RT. 1 BOX 44-A, PAULS VALLEY, OK 73075
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
08/22/2020
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