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General NPI Number Information
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NPI Number | 1568000966
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Entity Type | Organization
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Legal Business Name | SOUTHERN OKLAHOMA TREATMENT SERVICES, INC.
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 512 E 24TH ST
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City | TISHOMINGO
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State | OK
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Zip | 73460-3214
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Country | US
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Telephone | 580-371-3672
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1710
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City | KINGSTON
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State | OK
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Zip | 73439-1710
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Country | US
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Telephone | 580-564-7374
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Fax | 855-286-8580
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | BRE'YON JAMES
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Credential |
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Telephone | 918-490-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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