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General NPI Number Information
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NPI Number | 1699561043
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Entity Type | Organization
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Legal Business Name | STABLE RECOVERY, LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 301 S. SARA ROAD THE RANCH HOUSE
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City | MUSTANG
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State | OK
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Zip | 73064-7048
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Country | US
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Telephone | 405-397-9744
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Fax |
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Provider Business Mailing Address
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Address Line | 14215 SW 46TH COURT
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City | YUKON
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State | OK
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Zip | 73099-2842
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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 | OWNER
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Name | MS. LINDA HENDERSHOT
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Credential |
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Telephone | 405-397-9744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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