Provider Demographics
NPI:1083089122
Name:TRC THE RECOVERY CENTER
Entity Type:Organization
Organization Name:TRC THE RECOVERY CENTER
Other - Org Name:THE REFERRAL CENTER FOR ALCOHOL AND DRUG SERVICES OF CENTRAL OKLAHOMA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-525-2525
Mailing Address - Street 1:1215 NW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5629
Mailing Address - Country:US
Mailing Address - Phone:405-525-2525
Mailing Address - Fax:405-524-3549
Practice Address - Street 1:1215 NW 25TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106
Practice Address - Country:US
Practice Address - Phone:405-525-2525
Practice Address - Fax:405-524-3549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200079780BMedicaid
OK200079780Medicaid