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NPI Code Detail

MEDICARE: VIZOWN LLC

MEDICARE: VIZOWN LLC
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1558783589
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIZOWN LLC
Provider Business Mailing Address
First Line : 24962 OKAY RD
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-6504
Country : US
Telephone Number : 405-253-2020
Fax Number : 405-598-8227
Provider Business Practice Location Address
First Line : 24962 OKAY RD
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-6504
Country : US
Telephone Number : 405-253-2020
Fax Number : 405-598-8227
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : CHRISTOPHER 'KITT' J WAKELEY
Credential :
Telephone Number : 405-550-1750
Provider Enumeration Date : 01/10/2014
Last Update Date : 02/04/2015

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Directions to “VIZOWN LLC ” Practice Location

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