Healthcare Provider Details

I. General information

NPI: 1528529674
Provider Name (Legal Business Name): ROAD TO RECOVERY FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23899 STATE HIGHWAY 74
PURCELL OK
73080-6964
US

IV. Provider business mailing address

23899 STATE HIGHWAY 74
PURCELL OK
73080-6964
US

V. Phone/Fax

Practice location:
  • Phone: 405-253-3838
  • Fax: 405-527-1265
Mailing address:
  • Phone: 405-253-3838
  • Fax: 405-527-1265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JACOB WILSON HILL
Title or Position: CHIEF FINANCIAL & OPERATING OFFICER
Credential:
Phone: 405-253-3838