Healthcare Provider Details

I. General information

NPI: 1295940823
Provider Name (Legal Business Name): OKLAHOMA MENTAL HEALTH COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4404 N LINCOLN BLVD
OKLAHOMA CITY OK
73105-5104
US

IV. Provider business mailing address

4400 N LINCOLN BLVD
OKLAHOMA CITY OK
73105-5104
US

V. Phone/Fax

Practice location:
  • Phone: 405-424-7711
  • Fax: 405-425-0312
Mailing address:
  • Phone: 405-424-7711
  • Fax: 405-425-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. ALLYN S FRIEDMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.A.
Phone: 405-425-0355