Provider Demographics
NPI:1609011774
Name:SOUTHERN OKLAHOMA TREATMENT SERVICES, INC.
Entity Type:Organization
Organization Name:SOUTHERN OKLAHOMA TREATMENT SERVICES, INC.
Other - Org Name:ATOKA COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-371-3672
Mailing Address - Street 1:309 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-4227
Mailing Address - Country:US
Mailing Address - Phone:918-647-5396
Mailing Address - Fax:918-647-2085
Practice Address - Street 1:309 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4227
Practice Address - Country:US
Practice Address - Phone:918-647-5396
Practice Address - Fax:918-647-2085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health