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NPI Code Detail

MEDICARE: OXFORD TREATMENT CENTER, LLC

MEDICARE: OXFORD TREATMENT CENTER, LLC
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/CenterAAC-APH-01MS
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/CenterAAC-SO-01MS
3324500000XSubstance Abuse Rehabilitation FacilityAAC-PRS-01MS

General Provider Information

NPI Number : 1518341742
Entity Type Code : Organization
Provider Name (Legal Business Name) : OXFORD TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 500 WILSON PIKE CIR STE 360
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-3266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 297 COUNTY ROAD 244
Second Line :
City : ETTA
State : MS
Zip : 38627
Country : US
Telephone Number : 662-281-9992
Fax Number :
Authorized Official
Title or Position : FACILITY EXECUTIVE DIRECTOR
Name : PAIGE HAVENS
Credential :
Telephone Number : 662-281-9992
Provider Enumeration Date : 07/17/2015
Last Update Date : 06/10/2024

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Directions to “OXFORD TREATMENT CENTER, LLC ” Practice Location

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