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NPI Code Detail

MEDICARE: STAGES OF RECOVERY, INC

MEDICARE: STAGES OF RECOVERY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1033786025
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAGES OF RECOVERY, INC
Provider Business Mailing Address
First Line : 4101 N CLASSEN BLVD STE C
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-2413
Country : US
Telephone Number : 405-261-3223
Fax Number :
Provider Business Practice Location Address
First Line : 4101 N CLASSEN BLVD STE C
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-2413
Country : US
Telephone Number : 405-261-3223
Fax Number :
Authorized Official
Title or Position : CEO
Name : STEPHEN MEDLEY
Credential : BUSINESS ADMIN
Telephone Number : 817-600-8692
Provider Enumeration Date : 06/08/2021
Last Update Date : 06/08/2021

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Directions to “STAGES OF RECOVERY, INC ” Practice Location

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