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General NPI Number Information
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NPI Number | 1184089328
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Entity Type | Organization
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Legal Business Name | DOOR 2 UR FUTURE
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 1050 E 61ST ST APT 89
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City | TULSA
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State | OK
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Zip | 74136-1397
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Country | US
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Telephone | 210-954-6004
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 E 61ST APT 89
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City | TULSA
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State | OK
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Zip | 74136
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Country | US
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Telephone | 210-954-6004
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALICIA LYNN CASBY
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Credential |
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Telephone | 210-954-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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