Healthcare Provider Details

I. General information

NPI: 1134462187
Provider Name (Legal Business Name): COCMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 ALAMEDA ST
NORMAN OK
73070-5229
US

IV. Provider business mailing address

909 ALAMEDA ST
NORMAN OK
73071-5229
US

V. Phone/Fax

Practice location:
  • Phone: 405-360-5100
  • Fax:
Mailing address:
  • Phone: 405-360-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE P CAMP
Title or Position: PRSS, CASE MANAGER
Credential: PRSS, CASE MANAGER
Phone: 405-573-3984