Organization
COUNTRY ROAD OPERATIONS LLC
Active
Other names
Avenues of Oklahoma
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MANDELBAUM (CEO)
(718) 570-6018
Entity
Organization
Contact information
Practice address
24962 OKAY RD, TECUMSEH, OK 74873-6504
(405) 253-2020
Mailing address
24962 OKAY RD, TECUMSEH, OK 74873-6504
(405) 253-2020
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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