Organization
SOUTHWEST YOUTH AND FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK R WIDENER MHR (CEO)
(405) 222-5437
Entity
Organization
Contact information
Practice address
102 E BROADWAY ST, ANADARKO, OK 73005-2824
(405) 247-9777
(405) 247-9778
Mailing address
PO BOX 829, CHICKASHA, OK 73023-0829
(405) 247-9777
(405) 247-9778
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
909
ODMHSAS AGENCY ID
OK
Enumeration date
04/11/2007
Last updated
08/22/2020
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