Provider Demographics
NPI:1114269651
Name:OKMHSAS
Entity Type:Organization
Organization Name:OKMHSAS
Other - Org Name:COCMHC
Other - Org Type:Other Name
Authorized Official - Title/Position:RECOVERY SUPPORT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:CPRSS,CM
Authorized Official - Phone:405-573-3921
Mailing Address - Street 1:909 ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-5229
Mailing Address - Country:US
Mailing Address - Phone:405-360-5100
Mailing Address - Fax:
Practice Address - Street 1:909 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5229
Practice Address - Country:US
Practice Address - Phone:405-360-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health