Organization
ROADBACK INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK DAN PICKENS BA, CADC (EXECUTIVE DIRECTOR)
(580) 357-8114
Entity
Organization
Contact information
Practice address
1202 SW A AVE, LAWTON, OK 73501-3821
(580) 357-6889
(580) 357-4390
Mailing address
PO BOX 3198, 405 SW 15TH, LAWTON, OK 73502-3198
(580) 357-8114
(580) 353-3854
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/18/2006
Last updated
08/22/2020
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