Broadway House, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BROADWAY HOUSE, INC.

Practice address

221 2ND Ave NW
Ardmore, OK 73401-6202

Phone

(580) 226-3252

Fax

(580) 226-3849

NPI assigned

Apr 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Wadonna D Wells, MHR, LADCNPI 1801022181

Title

Executive Director

Phone

(580) 226-3252

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Wadonna Wells, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Ardmore, OK
  • NPI 1801022181
  NPD (past) Authorized official
• Jimmy A Jackson, TECH

  • Mental Health Counselor
  • Ardmore, OK
  • NPI 1376836957
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710106778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 2ND AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734016202",
            "telephone_number": "580-226-3252",
            "fax_number": "580-226-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 2ND AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734016202",
            "telephone_number": "580-226-3252",
            "fax_number": "580-226-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "WADONNA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-226-3252",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MHR, LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Lynae Brandenberger, PHARMD
• Amanda Carol Bratcher, BSW, CM-A
• Ricki Braziell
• Harley Brewer
• Hattie Alexandra Briggs
• Brad T Brogdon, LPC
• Amanda Rachelle Brooks
• Krista Raeann Brooks
• Stormi Brooks
• Jamilia Lashawn Broussard, MSN RN FNP-BC WCC

• Substance Abuse Rehabilitation Facility in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Substance Abuse Rehabilitation Facility in Oklahoma

• 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.