MEDICARE: MISSION TREATMENT CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM2800X	Methadone Clinic

General Provider Information

NPI Number	:	1508276007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSION TREATMENT CENTERS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 682669
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-2669
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1737 LINWOOD BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106
Country	:	US
Telephone Number	:	405-239-6815
Fax Number	:	405-239-2637

Authorized Official
Title or Position	:	VP & SECRETARY
Name	:	BRIAN PHILLIP FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	05/06/2014
Last Update Date	:	01/12/2026

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