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
109 S WILLOW ST, PAULS VALLEY, OK 73075-3833
(580) 223-5070
(580) 223-5617
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 223-5070
(580) 223-5617
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830 Z
—
OK
Enumeration date
01/29/2007
Last updated
12/12/2007
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