NPIMap

Organization Active NPI

Roadback Incorporated

  • Substance Abuse Rehabilitation Facility
  • Lawton, OK
National Provider Identifier
1467470310
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
ROADBACK INCORPORATED
Practice address
1202 SW a Ave
Lawton, OK 73501-3821
Phone
(580) 357-6889
Fax
(580) 357-4390
NPI assigned
Jul 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rick Dan Pickens, BA, CADC
Title
Executive Director
Phone
(580) 357-8114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1202 SW a Ave
Lawton, OK 73501-3821

Mailing address

PO Box 3198
405 SW 15TH
Lawton, OK 73502-3198
Phone (580) 357-8114

National Provider Directory

National Provider Directory
Tax ID family
Roadback Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1202 SW A Ave
Lawton, OK 73501
Phone (580) 357-6889

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467470310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3198",
            "address_2": "405 SW 15TH",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735023198",
            "telephone_number": "580-357-8114",
            "fax_number": "580-353-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 SW A AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735013821",
            "telephone_number": "580-357-6889",
            "fax_number": "580-357-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROADBACK INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PICKENS",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "DAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-357-8114",
        "authorized_official_credential": "BA, CADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.