Healthcare Provider Details

I. General information

NPI: 1639362254
Provider Name (Legal Business Name): OKLAHOMA TREATMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 SW 29TH ST
OKLAHOMA CITY OK
73179-7602
US

IV. Provider business mailing address

7134 S YALE AVE STE 560
TULSA OK
74136-6352
US

V. Phone/Fax

Practice location:
  • Phone: 405-616-3366
  • Fax: 405-616-4925
Mailing address:
  • Phone: 405-686-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: SCOTT THOMPSON
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 918-289-0270