Provider Demographics
NPI:1457842783
Name:AVENUES RECOVERY CENTER OF OKLAHOMA
Entity Type:Organization
Organization Name:AVENUES RECOVERY CENTER OF OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-223-4562
Mailing Address - Street 1:211 BOULEVARD OF THE AMERICAS
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5960
Mailing Address - Country:US
Mailing Address - Phone:732-307-8000
Mailing Address - Fax:
Practice Address - Street 1:24962 OKAY RD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:OK
Practice Address - Zip Code:74873-6504
Practice Address - Country:US
Practice Address - Phone:405-253-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility