| Mental Health Services Of Southern Oklahoma | |
|
200 Wanda St Marietta OK 73448 | |
| (580) 223-5070 | |
| (580) 223-5617 |
| Full Name | Mental Health Services Of Southern Oklahoma |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 200 Wanda St, Marietta, Oklahoma |
| Authorized Official Name and Position | Robert E Lee (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5802235070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Services Of Southern Oklahoma Po Box 189 Ardmore OK 73402-0189 Ph: (580) 223-5070 | Mental Health Services Of Southern Oklahoma 200 Wanda St Marietta OK 73448 Ph: (580) 223-5070 |
| NPI Number | 1295871499 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 12/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295871499 | NPI | - | NPPES |
| 100728830 I | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Love County Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Wanda St, Marietta, OK 73448 Phone: 580-276-1542 Fax: 580-276-1543 | |
Love County Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Wanda St, Marietta, OK 73448 Phone: 580-276-1542 Fax: 580-276-1543 |