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State Of Oklahoma
Medical Specialty Clinic/Center in Lawton, Oklahoma
NPI 1619012515

State Of Oklahoma is a Medical Specialty Clinic/Center based in Lawton, OK and is specialized in Medical Specialty. State Of Oklahoma practices in Lawton, OK. The NPI Number for State Of Oklahoma is 1619012515 and holds a License No. (Oklahoma).

The current practice location address for State Of Oklahoma is 602 Sw 38Th Street, Lawton, OK and can be reached out via phone at 580-248-5780 and via fax at 580-353-3202.

Location: 602 Sw 38Th Street, Lawton, OK, 73505-6912
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1619012515
Provider Name
State Of Oklahoma
Credential
Provider Entity Type
Organization
Address
602 Sw 38Th Street, Lawton, OK, 73505-6912
Phone Number
580-248-5780
Fax Number
580-353-3202
Provider Enumeration Date
02/20/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
WCDLG 01 OK MEDICARE PART B PROVIDER NUMBER
100677270A 05 OK
100755860A 05 OK
100688870A 05 OK
institution
Provider Business Practice Location Address Details
Address
602 Sw 38Th Street
City
Lawton
State
Oklahoma
Zip
73505-6912
Phone Number
580-248-5780
Fax Number
580-353-3202
person
Provider Business Mailing Address Details
Address
602 Sw 38Th Street
City
Lawton
State
Oklahoma
Zip
73505-6912
Phone Number
580-248-5780
Fax Number
580-353-3202
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
0005111 (Oklahoma)
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
0005111 (Oklahoma)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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