Provider Demographics
NPI:1700024007
Name:SOUTHERN OKLAHOMA TREATMENT SERICES, INC.
Entity Type:Organization
Organization Name:SOUTHERN OKLAHOMA TREATMENT SERICES, INC.
Other - Org Name:
Other - Org Type:
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:508-745-9610
Mailing Address - Street 1:6 SOUTHEAST AVENUE A
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745
Mailing Address - Country:US
Mailing Address - Phone:508-286-5262
Mailing Address - Fax:580-286-5595
Practice Address - Street 1:6 SOUTHEAST AVENUE A
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745
Practice Address - Country:US
Practice Address - Phone:508-286-5262
Practice Address - Fax:580-286-5595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management