Healthcare Provider Details

I. General information

NPI: 1790803286
Provider Name (Legal Business Name): THE CENTER FOR THERAPEUTIC INTERVENTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7477 E 46TH PL
TULSA OK
74145-6305
US

IV. Provider business mailing address

7477 E 46TH PL
TULSA OK
74145-6305
US

V. Phone/Fax

Practice location:
  • Phone: 918-384-0002
  • Fax: 918-384-0004
Mailing address:
  • Phone: 918-384-0002
  • Fax: 918-384-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANET KAYE CIZEK
Title or Position: PRESIDENT CEO
Credential: LPC LADC
Phone: 918-384-0002