Healthcare Provider Details
I. General information
NPI: 1689470106
Provider Name (Legal Business Name): OKLAHOMA TREATMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1613 SE 66TH ST
OKLAHOMA CITY OK
73149-5203
US
IV. Provider business mailing address
7134 S YALE AVE STE 560
TULSA OK
74136-6352
US
V. Phone/Fax
- Phone: 405-616-3366
- Fax:
- Phone: 405-616-3366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
THOMPSON
Title or Position: CEO
Credential:
Phone: 918-289-0270