Provider Demographics
NPI:1649802117
Name:EVEREST REHABILITATION HOSPITAL OKC, LLC
Entity type:Organization
Organization Name:EVEREST REHABILITATION HOSPITAL OKC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:TESS
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-731-8801
Mailing Address - Street 1:7900 MID AMERICA BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-6609
Mailing Address - Country:US
Mailing Address - Phone:405-251-9622
Mailing Address - Fax:
Practice Address - Street 1:7900 MID AMERICA BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-6609
Practice Address - Country:US
Practice Address - Phone:405-251-9622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital