Provider Demographics
NPI:1922865039
Name:OUR HOUSE MHSA D&L
Entity Type:Organization
Organization Name:OUR HOUSE MHSA D&L
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEWEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-647-7246
Mailing Address - Street 1:2305 SW H AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-8103
Mailing Address - Country:US
Mailing Address - Phone:800-920-6313
Mailing Address - Fax:
Practice Address - Street 1:125 N 10TH ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4611
Practice Address - Country:US
Practice Address - Phone:580-319-7694
Practice Address - Fax:580-699-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty