OrganizationActive
Integrated Renegade, LLC
NPI 1366223265 · Community/Behavioral Health Agency · Glenpool, OK
Integrated Renegade, LLC is a Community/Behavioral Health Agency organization in Glenpool, OK (NPI 1366223265).
Provider details
- NPI number
- 1366223265
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Petra Russell, Owner(918) 321-0697
Specialties & taxonomies
Agencies
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1264 E 139th Pl
Glenpool, OK 74033-3125
Phone: (918) 321-0697
Street-level locationGet directions
Mailing address
1264 E 139th Pl
Glenpool, OK 74033-3125
Registry dates
- Enumerated
- 2023-10-09
- Last updated
- 2023-10-09
- Certified
- 2023-10-08
Frequently asked questions
- What is Integrated Renegade, LLC's NPI number?
- Integrated Renegade, LLC's National Provider Identifier (NPI) is 1366223265, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Integrated Renegade, LLC?
- Integrated Renegade, LLC is classified in the NPPES registry as Community/Behavioral Health Agency (Agencies).
- Where is Integrated Renegade, LLC located?
- Integrated Renegade, LLC's practice location on file with NPPES is 1264 E 139th Pl, Glenpool, OK 74033-3125.
- What is Integrated Renegade, LLC's phone number?
- The practice phone number listed in the NPPES registry for Integrated Renegade, LLC is (918) 321-0697.
- Who is the authorized official for Integrated Renegade, LLC?
- The authorized official listed on Integrated Renegade, LLC's NPPES record is Petra Russell, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Integrated Renegade, LLC's NPI active?
- Yes — Integrated Renegade, LLC's NPI (1366223265) is active in the NPPES registry as of the last update on 2023-10-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.