Healthcare Provider Details

I. General information

NPI: 1609723014
Provider Name (Legal Business Name): ADAPTIVE PATHWAYS GROUP OF OKLAHOMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 W MAIN ST # 1032
OKLAHOMA CITY OK
73102-2221
US

IV. Provider business mailing address

629 W MAIN ST # 1032
OKLAHOMA CITY OK
73102-2221
US

V. Phone/Fax

Practice location:
  • Phone: 405-417-7801
  • Fax:
Mailing address:
  • Phone: 405-417-7801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: WILDINE BURGESS
Title or Position: EXECUTIVE ADMIN
Credential:
Phone: 405-417-7801