MEDICARE: SPECIALIZED OUTPATIENT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	291

General Provider Information

NPI Number	:	1063624351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALIZED OUTPATIENT SERVICES

Provider Business Mailing Address
First Line	:	5208 CLASSEN CIR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-4429
Country	:	US
Telephone Number	:	405-810-1766
Fax Number	:	405-810-0331

Provider Business Practice Location Address
First Line	:	5208 CLASSEN CIR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-4429
Country	:	US
Telephone Number	:	405-810-1766
Fax Number	:	405-810-0331

Authorized Official
Title or Position	:	ADOLESCENT PROGRAM DIRECTOR
Name	:	MR. MIKE JAMES MADDOX
Credential	:	CADC
Telephone Number	:	405-810-1766

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1326079930 — RITA AGNES CROCKETT LPC, LADC
Practice Location Address:

5228 CLASSEN CIR
OKLAHOMA CITY, OK
73118-4429

Practice Phone: 405-840-9000
Practice Fax: 405-840-9017

1821101551 — MR. EDWIN LEE MILLER JR. MDIV MHR LPC LMFT LA
Practice Location Address:

5208 CLASSEN CIR
OKLAHOMA CITY, OK
73118-4429

Practice Phone: 405-848-2370
Practice Fax: 405-810-0331

1043434368 — SPECIALIZED OUTPATIENT SERVICES, INC.
Practice Location Address:

5208 CLASSEN CIRCLE
OKLAHOMA CITY, OK
73118-4429

Practice Phone: 405-810-1766
Practice Fax: 405-810-0331

1982826673 — MS. SHIRLEY JOYCE BECKENHAUER LADC
Practice Location Address:

5208 CLASSEN CIR
OKLAHOMA CITY, OK
73118-4429

Practice Phone: 405-810-1766
Practice Fax: 405-810-0331

1144432972 — JOHN C. CULLEN CADC
Practice Location Address:

5208 CLASSEN CIR
OKLAHOMA CITY, OK
73118-4429

Practice Phone: 405-810-1766
Practice Fax: 405-810-0331

1205048576 — SPECIALIZED OUTPATIENT SERVICES
Practice Location Address:

5208 CLASSEN CIR
OKLAHOMA CITY, OK
73118-4429

Practice Phone: 405-810-1766
Practice Fax:

Directions to “SPECIALIZED OUTPATIENT SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.