Organization
STATE OF OKLAHOMA
Active
Other names
JIM TALIAFERRO COMMUNITY MENTAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI LEE LPC (EXECUTIVE DIRECTOR)
(580) 250-2640
Entity
Organization
Contact information
Practice address
602 SW 38TH STREET, LAWTON, OK 73505-6912
(580) 248-5780
(580) 353-3202
Mailing address
602 SW 38TH STREET, LAWTON, OK 73505-6912
(580) 248-5780
(580) 353-3202
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0005111
OK
283Q00000X
Psychiatric Hospital
Primary
0005111
OK
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100677270A
—
OK
05
—
100688870A
—
OK
05
—
100700660A
—
OK
05
—
100706940L
—
OK
05
—
1007558860A
—
OK
Enumeration date
07/20/2005
Last updated
01/30/2024
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