Provider Demographics
NPI:1730465410
Name:COUNSELING AND RECOVERY
Entity Type:Organization
Organization Name:COUNSELING AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PROJECT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC(US)
Authorized Official - Phone:918-492-2554
Mailing Address - Street 1:7010 S.YALE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-492-2554
Mailing Address - Fax:918-495-0779
Practice Address - Street 1:7010 S.YALE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-492-2554
Practice Address - Fax:918-495-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management