Healthcare Provider Details

I. General information

NPI: 1104747666
Provider Name (Legal Business Name): PROPEL SOBER LIVING HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 W HASKELL ST
TULSA OK
74127-5212
US

IV. Provider business mailing address

2112 W HASKELL ST
TULSA OK
74127-5212
US

V. Phone/Fax

Practice location:
  • Phone: 918-814-1677
  • Fax:
Mailing address:
  • Phone: 918-814-1677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: GENEAN STUTTLEY
Title or Position: PROGRAM OPERATOR
Credential:
Phone: 918-814-1677