Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Integrated Renegade, LLC

Organization Community/Behavioral Health Agency · NPI 1366223265

Integrated Renegade, LLC is a Community/Behavioral Health Agency in Glenpool, Oklahoma. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1264 E 139th Pl
Glenpool, OK 74033-3125
Phone: (918) 321-0697
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X

Record details

NPI number1366223265
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Petra Russell — Owner · (918) 321-0697
NPI enumeratedOctober 9, 2023
Last updated in NPPESOctober 9, 2023
Certification dateOctober 8, 2023
Mailing address1264 E 139th Pl, Glenpool, OK 74033-3125