CONVALESCE (NPI# 1639524994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639524994 |
| Entity Type | Organization |
| Organization Name | CONVALESCE |
| Practice Address |
626 N Broadway St Moore OK 73160-4814 |
| Practice Telephone | 4054308917 |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |
| Authorized Official Name | CHRISTIANE LANGE (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4054308917 |
| Authorized Official Credential | MS/LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 5734 | OK | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Convalescence Counseling LLC | 820 Sunrise Avenue, Fort Collins, CO 80524 |
| New York State Corporations | CONVALESCENCE LLC | 13442 227th St, Laurelton, Ny 11413 |
| System for Award Management (SAM) Entities | CONVALESCENT CARE | 1010 13th St, Columbus, GA 31901-2239 |
| System for Award Management (SAM) Entities | CONVALESCENT CENTER | 503 E 4th St, Grant City, MO 64456-8363 |
| Virginia Business Entities | CONVALESCENT CENTER INC. | 1600 Westover Drive, Sanford, North Carolina 27330 |
| System for Award Management (SAM) Entities | CONVALESCENT CENTER OF HONOLULU, THE | 1900 Bachelot St, Honolulu, HI 96817-2431 |
| Virginia Business Entities | CONVALESCENT CENTER OF LEE COUNTY INC. | 1600 Westover Drive, Sanford, North Carolina 27330 |
| North Carolina Corporations | CONVALESCENT CENTER OF LEE COUNTY INC. | 2840 Plaza Place, Ste 400, Raleigh, NC 27612 |
| Virginia Business Entities | CONVALESCENT CENTER OF SANFORD INC. | 1600 Westover Drive, Sanford, North Carolina 27330 |
| Ohio Business Entities | CONVALESCENT NURSING HOSPITAL CORP. | 20 1/2 W Boardman St, Youngstown, OH |
| Street Address |
626 N BROADWAY ST |
| City | MOORE |
| State | OK |
| Zip Code | 73160-4814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669767257 | Genesi LLC | Community/Behavioral Health | 626 N Broadway St, Moore, OK 73160-4814 | 2011-06-13 |
| 1558887356 | Ida S Kemunto Magati | Counselor | 626 N Broadway St, Moore, OK 73160-4814 | 2017-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336481 | Share More Ctc, LLC | Community/Behavioral Health | 2000 N Broadway St Ste B, Moore, OK 73160-4416 | 2020-02-03 |
| 1295086940 | Emma Lea Schartner | Community/Behavioral Health | 1821 Sunrise Dr, Moore, OK 73160-3510 | 2012-09-20 |
| 1669767257 | Genesi LLC | Community/Behavioral Health | 626 N Broadway St, Moore, OK 73160-4814 | 2011-06-13 |
| 1720417587 | Odmhasa | Community/Behavioral Health | 717 N Dillon Ave, Moore, OK 73160-3716 | 2013-11-02 |
| 1740517366 | Distinctive Adolescent and Adult Guidance Counseling Services | Community/Behavioral Health | 2119 Riverwalk Dr # 218, Moore, OK 73160-2700 | 2009-11-04 |
| 1578716775 | Evolution: Changing Paths Through Talk Therapy LLC | Community/Behavioral Health | 121 W Main St, Suit 103, Moore, OK 73160-5136 | 2008-10-31 |
| 1205056546 | Moore Alcohol and Drug Center | Community/Behavioral Health | 624 Nw 5th St, Moore, OK 73160-3924 | 2007-04-27 |
| 1487871695 | Moore Youth and Family Services | Community/Behavioral Health | 624 Nw 5th St, Moore, OK 73160-3924 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1427656909 | Against All Odds Youth and Family Services | Community/Behavioral Health | 2701 Nw 185th St, Edmond, OK 73012-9795 | 2020-10-15 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1477170322 | Glostars LLC | Community/Behavioral Health | 19704 Vivace Dr, Edmond, OK 73012-5232 | 2020-06-26 |
| 1780201798 | Canadian County Collaborative LLC | Community/Behavioral Health | 1703 Professional Cir Ste 201, Yukon, OK 73099-6498 | 2020-06-26 |
| 1235754458 | New Life Counseling Center | Community/Behavioral Health | 1206 N Hwy 81, Duncan, OK 73533-1790 | 2020-06-12 |
| 1770108946 | Meadow Hazelhoff Counseling, LLC | Community/Behavioral Health | 9524 Conners Way, Mcloud, OK 74851-8668 | 2020-06-12 |
| 1407477920 | Keetoowah Economic Development | Community/Behavioral Health | 16414 W 760 Rd, Tahlequah, OK 74464-1675 | 2020-05-06 |
| 1356981138 | Grand Lake Mental Health Center Inc | Community/Behavioral Health | 2225 N Union, Ponca City, OK 74601-1536 | 2020-01-09 |
| 1083253819 | Mindful Well Being Counseling Services LLC | Community/Behavioral Health | 203 S Mckenna St, Poteau, OK 74953-4322 | 2019-12-26 |
| Find all providers with the same taxonomy | ||||
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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.