Provider Demographics
NPI:1649457284
Name:ASSOCIATION SOUTH CENTRAL OKLAHOMA GOVERNMENTS
Entity type:Organization
Organization Name:ASSOCIATION SOUTH CENTRAL OKLAHOMA GOVERNMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BLAINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:580-252-0595
Mailing Address - Street 1:802 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4616
Mailing Address - Country:US
Mailing Address - Phone:580-252-0595
Mailing Address - Fax:580-252-6170
Practice Address - Street 1:802 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4616
Practice Address - Country:US
Practice Address - Phone:580-252-0595
Practice Address - Fax:580-252-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management