Healthcare Provider Details

I. General information

NPI: 1699653402
Provider Name (Legal Business Name): OKC BH OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N COUNCIL RD
OKLAHOMA CITY OK
73127-4980
US

IV. Provider business mailing address

701 N COUNCIL RD
OKLAHOMA CITY OK
73127-4980
US

V. Phone/Fax

Practice location:
  • Phone: 405-400-7071
  • Fax:
Mailing address:
  • Phone: 405-400-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: TARA M MICHELLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 405-204-3217