STATE OF OKLAHOMA

LAWTON, OK
NPI1619012515
Doing Business AsJIM TALIAFERRO CMHC
Entity TypeOrganization
Authorized ContactTERRI LEE
Executive Director
580-250-2640
Organization Subpart ?Yes
Primary Taxonomy261QM0801X 
(Licence: OK  0005111)
Additional Taxonomies261QM2500X Clinic/Center, Medical Specialty
(Licence: OK  0005111)
261QM2500X Clinic/Center, Medical Specialty
251S00000X Community/Behavioral Health
Enumeration Date2007-02-20
Last Update Date2024-01-30
Business Address
STATE OF OKLAHOMA
602 SW 38TH STREET
LAWTON, OK 73505-6912
Phone number: 580-248-5780
Mailing Address
STATE OF OKLAHOMA
602 SW 38TH STREET
LAWTON, OK 73505-6912
Phone number: 580-248-5780