LANDMARK RECOVERY OUTPATIENT SERVICES, LLC (NPI# 1194297341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194297341 |
| Entity Type | Organization |
| Organization Name | LANDMARK RECOVERY OUTPATIENT SERVICES, LLC |
| Practice Address |
1805 E 15th St Tulsa OK 74104-4610 |
| Mailing Address |
4835 E Cactus Rd Ste 130 Scottsdale AZ 85254-3545 |
| Practice Telephone | 8884480302 |
| Mailing Telephone | 8884480302 |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |
| Authorized Official Name | JESSICA PROCHUT (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 4806198556 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Landmark Recovery of Tulsa Outpatient Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821562919 | Landmark Recovery Outpatient Services, LLC | Clinic/Center | 4825 Nw 23rd St, Oklahoma City, OK 73127-1800 | 2019-01-11 |
| Street Address |
1805 E 15TH ST |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982881686 | Jennifer Gibbens Md Pllc | Obstetrics & Gynecology | 1805 E 15th St, Tulsa, OK 74104-4610 | 2008-01-24 |
| 1558796508 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Psychologist | 1805 E 15th St, Tulsa, OK 74104-4610 | 2013-09-10 |
| 1154689743 | Osu Center for Health Sciences | Clinic/Center | 1805 E 15th St, Tulsa, OK 74104-4610 | 2012-05-02 |
| 1235403023 | Newborn Specialists of Tulsa, PC | Pediatrics | 1805 E 15th St, Tulsa, OK 74104-4610 | 2012-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003304254 | Serenity Counseling LLC | Clinic/Center | 5103 S Sheridan Rd # 323, Tulsa, OK 74145-7627 | 2018-04-24 |
| 1912337643 | Latanya Dodd | Clinic/Center | 1540 E 68th Pl, Tulsa, OK 74136 | 2013-11-15 |
| 1679764807 | Riverside Counseling Services | Clinic/Center | 5272 S Lewis Ave Ste 250, Tulsa, OK 74105-6564 | 2007-08-05 |
| 1396373064 | Sublime Therapy Group LLC | Clinic/Center | 4815 S Harvard Ave Ste 480, Tulsa, OK 74135-3050 | 2020-03-30 |
| 1134750649 | Parkside, Inc. | Clinic/Center | 1239 S Trenton Ave, Tulsa, OK 74120-5420 | 2020-02-03 |
| 1902367618 | Ketcen of Tulsa LLC | Clinic/Center | 9840 E 81st St Ste 100, Tulsa, OK 74133-4583 | 2019-03-26 |
| 1841763406 | J Ross Inc. | Clinic/Center | 5215 E 71st St, Tulsa, OK 74136-6341 | 2019-01-07 |
| 1093234361 | Joseph Nowicki | Clinic/Center | 2323 S Harvard Ave, Tulsa, OK 74114-3301 | 2017-09-18 |
| 1740621549 | Peter Alan Rao, M.d., Pllc | Clinic/Center | 5544 S Lewis Ave, Suite 600, Tulsa, OK 74105-7105 | 2013-07-10 |
| 1083740351 | Alternative Opportunities Inc. | Clinic/Center | 5525 E 51st St, Suite #400, Tulsa, OK 74135-7461 | 2007-02-23 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.