Provider Demographics
NPI:1619845559
Name:AMAZING LIFE BEHAVIORAL HEALTH AND ADDICTION SERVICES
Entity type:Organization
Organization Name:AMAZING LIFE BEHAVIORAL HEALTH AND ADDICTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-476-8056
Mailing Address - Street 1:212 W OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-3132
Mailing Address - Country:US
Mailing Address - Phone:405-654-9813
Mailing Address - Fax:
Practice Address - Street 1:212 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-3132
Practice Address - Country:US
Practice Address - Phone:405-654-9813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty