Provider Demographics
NPI:1437880481
Name:DRY LIVING CENTER OF OKLAHOMA
Entity Type:Organization
Organization Name:DRY LIVING CENTER OF OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-991-5339
Mailing Address - Street 1:2639 S PITTSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-4727
Mailing Address - Country:US
Mailing Address - Phone:918-991-5339
Mailing Address - Fax:
Practice Address - Street 1:3336 E 32ND ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-4448
Practice Address - Country:US
Practice Address - Phone:918-727-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED MARKETING SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center