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General NPI Number Information
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NPI Number | 1790205664
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Entity Type | Organization
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Legal Business Name | VIZARC LLC
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Dates
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Enumeration Date | 06/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 700 NW 7TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-1212
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Country | US
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Telephone | 405-553-1197
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Fax | 405-553-1188
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Provider Business Mailing Address
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Address Line | 700 NW 7TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-1212
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Country | US
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Telephone | 405-553-1197
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Fax | 405-553-1188
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Authorized Official
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Title or Position | VP OF THE ARC
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Name | AMY WOOLERY
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Credential |
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Telephone | 405-553-1197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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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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