Healthcare Provider Details

I. General information

NPI: 1194689281
Provider Name (Legal Business Name): STONE & SAGE SOBER LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 NW 22ND ST
LAWTON OK
73505-3901
US

IV. Provider business mailing address

412 NW 57TH ST
LAWTON OK
73505-5715
US

V. Phone/Fax

Practice location:
  • Phone: 714-951-2257
  • Fax:
Mailing address:
  • Phone: 714-951-2257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY QUICK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 714-951-2257