Providence Service Corporation of Oklahoma

NPI #1033279443 in Lawton, Oklahoma

Provider Information

NPI Number: 1033279443
Entity Type: Organization
Organization Name: Providence Service Corporation of Oklahoma
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Dec 8, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 4645 W GORE BLVD STE 5
City: Lawton
State: Oklahoma
ZIP Code: 73505-5962
Phone: (580) 355-6800

Authorized Official

Name: BREEANN MARIE HOERNING
Title: AR AND BILLING MANAGER
Phone: (520) 747-6600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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