Provider Demographics
NPI:1184822025
Name:OKLAHOMA ADDICTION SPECIALISTS INC SERVICES
Entity Type:Organization
Organization Name:OKLAHOMA ADDICTION SPECIALISTS INC SERVICES
Other - Org Name:O.A.S.I.S.
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:580-234-8222
Mailing Address - Street 1:PO BOX 641
Mailing Address - Street 2:404 N GRAND
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-3215
Mailing Address - Country:US
Mailing Address - Phone:580-234-8222
Mailing Address - Fax:580-234-8820
Practice Address - Street 1:404 N GRAND
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3215
Practice Address - Country:US
Practice Address - Phone:580-234-8222
Practice Address - Fax:580-234-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK244251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health