Organization
JIM TALIAFERRO COMMUNITY MENTAL HEALTH CENTER
Active
Organization
JIM TALIAFERRO COMMUNITY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FETIMA WELLINGTON (CASE MANAGER)
(580) 355-0072
Entity
Organization
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 355-0072
(580) 355-0232
Mailing address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 355-0072
(580) 355-0232
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2612MQM0801X
OK
Other
Enumeration date
02/17/2011
Last updated
10/25/2011
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