Provider Demographics
NPI:1790205664
Name:VIZARC LLC
Entity Type:Organization
Organization Name:VIZARC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF THE ARC
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-553-1197
Mailing Address - Street 1:700 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1212
Mailing Address - Country:US
Mailing Address - Phone:405-553-1197
Mailing Address - Fax:405-553-1188
Practice Address - Street 1:700 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1212
Practice Address - Country:US
Practice Address - Phone:405-553-1197
Practice Address - Fax:405-553-1188
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALIR WELLNESS, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty