Organization
SOUTHERN OKLAHOMA TREATMENT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON EVANS (C.E.O.)
(580) 371-3672
Entity
Organization
Contact information
Practice address
512 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-3672
(580) 371-3651
Mailing address
5862 HWY 70, MEAD, OK 73449
(580) 371-3672
(580) 371-3651
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049040 C
—
OK
Enumeration date
11/07/2006
Last updated
11/09/2009
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