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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