IndividualActive
Kimberly Kelly-Lorenz
NPI 1093127979 · Substance Abuse Rehabilitation Facility · Canadian, OK
Provider details
- NPI number
- 1093127979
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
163 Mohawk Dr
Canadian, OK 74425-9747
Phone: (918) 339-5800
Fax: (918) 339-5801
Approximate (ZIP-level) locationGet directions
Mailing address
163 Mohawk Dr
Canadian, OK 74425-9747
Registry dates
- Enumerated
- 2014-05-27
- Last updated
- 2014-05-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.