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General NPI Number Information
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NPI Number | 1538987664
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Entity Type | Organization
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Legal Business Name | OKLAHOMA RECOVERY CENTER, LLC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 4825 NW 23RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73127-1808
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Country | US
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Telephone | 949-531-1821
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33406-5957
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KYLEE BRINEY
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Credential |
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Telephone | 949-531-1821
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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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