Organization
COPE
Active
Other names
COPE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIE L HASKINS JR. PH. D. (EXECUTIVE DIRECTOR)
(405) 528-8686
Entity
Organization
Contact information
Practice address
2701 N OKLAHOMA AVE, OKLAHOMA CITY, OK 73105-2724
(405) 528-8686
(405) 528-8692
Mailing address
2701 N OKLAHOMA AVE, OKLAHOMA CITY, OK 73105-2724
(405) 528-8686
(405) 528-8692
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
OK
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
OK
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100742400B
—
OK
05
—
100742400D
—
OK
05
—
100742400F
—
OK
Enumeration date
03/05/2007
Last updated
04/01/2015
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