Healthcare Provider Details

I. General information

NPI: 1104049733
Provider Name (Legal Business Name): PALMER CONTINUUM OF CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2442 MOHAWK BLVD
TULSA OK
74110-1519
US

IV. Provider business mailing address

P.O. BOX 580700
TULSA OK
74158
US

V. Phone/Fax

Practice location:
  • Phone: 918-430-0975
  • Fax: 918-430-0995
Mailing address:
  • Phone: 918-832-7764
  • Fax: 918-832-7765

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: ELIZABETH NEAS
Title or Position: EXECUTIVE DIRECTOR
Credential: MHR
Phone: 918-900-2404