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NPI Code Detail

MEDICARE: SOUTHEASTERN OKLAHOMA FAMILY SERVICES, INC.

MEDICARE: SOUTHEASTERN OKLAHOMA FAMILY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1952972341
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEASTERN OKLAHOMA FAMILY SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 466
Second Line :
City : EUFAULA
State : OK
Zip : 74432-0466
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 113653 OLD HIGHWAY 69
Second Line :
City : CHECOTAH
State : OK
Zip : 74426-8802
Country : US
Telephone Number : 580-795-6377
Fax Number :
Authorized Official
Title or Position : CEO
Name : VIRGINIA HULL
Credential :
Telephone Number : 580-564-7374
Provider Enumeration Date : 07/07/2021
Last Update Date : 07/07/2021

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Directions to “SOUTHEASTERN OKLAHOMA FAMILY SERVICES, INC. ” Practice Location

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