Provider Demographics
NPI:1790112647
Name:RED ROAD COUNSELING LLC
Entity Type:Organization
Organization Name:RED ROAD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-990-0816
Mailing Address - Street 1:1004 CHOCTAW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6127
Mailing Address - Country:US
Mailing Address - Phone:405-990-0816
Mailing Address - Fax:
Practice Address - Street 1:1004 CHOCTAW RIDGE RD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6127
Practice Address - Country:US
Practice Address - Phone:405-990-0816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health