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General NPI Number Information
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NPI Number | 1407793896
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Entity Type | Organization
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Legal Business Name | ADDICTION RESOURCES LLC
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Dates
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Enumeration Date | 05/02/2026
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Last Update Date | 05/02/2026
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Provider Practice Location Address
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Address Line | 4847 KIBLER RD
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City | VAN BUREN
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State | AR
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Zip | 72956-8407
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Country | US
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Telephone | 918-705-0960
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Fax |
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Provider Business Mailing Address
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Address Line | 15330 W WAGON TRAIL RD
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City | PARK HILL
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State | OK
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Zip | 74451-2145
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Country | US
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Telephone | 918-705-0960
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZACK MODE
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Credential |
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Telephone | 918-705-0960
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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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