Organization
JIM TALIAFERRO CMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY HONEYCUTT (COORDINATOR)
(580) 355-0072
Entity
Organization
Contact information
Practice address
327 SW C AVE, LAWTON, OK 73501-4016
(580) 355-0072
Mailing address
327 SW C AVE, LAWTON, OK 73501-4016
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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