Organization
MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E. LEE LCSW (EXECUTIVE DIRECTOR)
(580) 223-5070
Entity
Organization
Contact information
Practice address
93 BROADLAWN VILLAGE, ARDMORE, OK 73401-1722
(580) 223-2537
(580) 223-2487
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 223-5070
(580) 223-5617
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830
—
OK
Enumeration date
07/24/2008
Last updated
07/24/2008
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