Provider Demographics
NPI:1073780573
Name:OXFORD RECOVERY CENTER
Entity Type:Organization
Organization Name:OXFORD RECOVERY CENTER
Other - Org Name:OXFORD HYPERBARIC OXYGEN CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMELA
Authorized Official - Middle Name:OXFORD
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-486-3636
Mailing Address - Street 1:7030 WHITMORE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8533
Mailing Address - Country:US
Mailing Address - Phone:248-486-3636
Mailing Address - Fax:248-486-0686
Practice Address - Street 1:7030 WHITMORE LAKE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8533
Practice Address - Country:US
Practice Address - Phone:248-486-3636
Practice Address - Fax:248-486-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty