Provider Demographics
NPI:1639362254
Name:OKLAHOMA TREATMENT SERVICES LLC
Entity Type:Organization
Organization Name:OKLAHOMA TREATMENT SERVICES LLC
Other - Org Name:RIGHTWAY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHAJINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-548-6954
Mailing Address - Street 1:7136 S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6373
Mailing Address - Country:US
Mailing Address - Phone:405-922-7750
Mailing Address - Fax:
Practice Address - Street 1:5401 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73179-7602
Practice Address - Country:US
Practice Address - Phone:405-616-3366
Practice Address - Fax:405-616-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center