| Southern Oklahoma Treatment Services, Inc. | |
|
512 E 24th St Tishomingo OK 73460-3214 | |
| (580) 371-3672 | |
| Not Available |
| Full Name | Southern Oklahoma Treatment Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 512 E 24th St, Tishomingo, Oklahoma |
| Authorized Official Name and Position | Bre'yon James (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9184903800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oklahoma Treatment Services, Inc. Po Box 1710 Kingston OK 73439-1710 Ph: (580) 564-7374 | Southern Oklahoma Treatment Services, Inc. 512 E 24th St Tishomingo OK 73460-3214 Ph: (580) 371-3672 |
| NPI Number | 1568000966 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 12/09/2025 |
| Certification Date | 12/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568000966 | NPI | - | NPPES |
| 200428190I | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Southern Oklahoma Treatment Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 512 E 24th St, Tishomingo, OK 73460 Phone: 580-371-3672 Fax: 580-371-3651 | |
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