| Life Recovery Services | |
|
5113 Se 15th St Ste D Del City OK 73115-3952 | |
| (580) 304-9770 | |
| Not Available |
| Full Name | Life Recovery Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5113 Se 15th St Ste D, Del City, Oklahoma |
| Authorized Official Name and Position | William Cody Shoemaker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5803049770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Recovery Services 5113 Se 15th St Ste D Del City OK 73115-3952 Ph: (580) 304-9770 | Life Recovery Services 5113 Se 15th St Ste D Del City OK 73115-3952 Ph: (580) 304-9770 |
| NPI Number | 1871972190 |
|---|---|
| Provider Enumeration Date | 05/19/2015 |
| Last Update Date | 05/19/2015 |
| Medicare PECOS PAC ID | 2062832975 |
|---|---|
| Medicare Enrollment ID | O20201014003754 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871972190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Oklahoma) | Primary |
| Provider Name | Eileen M Whitson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457514705 PECOS PAC ID: 7810925310 Enrollment ID: I20050929001029 |
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