Provider Demographics
NPI:1518611862
Name:COUNSELING & RECOVERY SERVICES OF OKLAHOMA, INC.
Entity Type:Organization
Organization Name:COUNSELING & RECOVERY SERVICES OF OKLAHOMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-392-5811
Mailing Address - Street 1:7010 S YALE AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5743
Mailing Address - Country:US
Mailing Address - Phone:918-492-2554
Mailing Address - Fax:918-477-9201
Practice Address - Street 1:6126 E 32ND PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5406
Practice Address - Country:US
Practice Address - Phone:918-394-2256
Practice Address - Fax:918-394-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)