Healthcare Provider Details

I. General information

NPI: 1306277082
Provider Name (Legal Business Name): OKLAHOMA TREATMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 S SHERIDAN RD
TULSA OK
74145-1105
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 918-610-3366
  • Fax: 918-610-3344
Mailing address:
  • Phone: 405-922-7750
  • 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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KORDARYL THOMAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 720-689-4706