Provider Demographics
NPI:1073154662
Name:LANDMARK RECOVERY OF OKLAHOMA CITY OPS LLC
Entity Type:Organization
Organization Name:LANDMARK RECOVERY OF OKLAHOMA CITY OPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYOR CONTRACTING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:VITUALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-282-1405
Mailing Address - Street 1:720 COOL SPRINGS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4825 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-1800
Practice Address - Country:US
Practice Address - Phone:405-594-2492
Practice Address - Fax:405-212-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility