Provider Demographics
NPI:1891061636
Name:OKLAHOMA CRISIS RECOVERY UNIT
Entity type:Organization
Organization Name:OKLAHOMA CRISIS RECOVERY UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION DIRECTOR REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:FANCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-573-3949
Mailing Address - Street 1:2625 GENERAL PERSHING BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-6437
Mailing Address - Country:US
Mailing Address - Phone:405-948-9373
Mailing Address - Fax:405-579-8741
Practice Address - Street 1:2625 GENERAL PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6437
Practice Address - Country:US
Practice Address - Phone:405-948-9373
Practice Address - Fax:405-579-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)