MEDICARE: DAILY LIVING CENTERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor	DC55035503	OK
2	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1164429882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAILY LIVING CENTERS, INC

Provider Business Mailing Address
First Line	:	P.O. BOX 608
Second Line	:
City	:	BETHANY
State	:	OK
Zip	:	73008
Country	:	US
Telephone Number	:	405-792-2401
Fax Number	:	405-792-2405

Provider Business Practice Location Address
First Line	:	3000 N ROCKWELL AVE
Second Line	:
City	:	BETHANY
State	:	OK
Zip	:	73008
Country	:	US
Telephone Number	:	405-792-2401
Fax Number	:	405-792-2405

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	JESSICA ANN CLAYTON
Credential	:
Telephone Number	:	405-792-2401

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/07/2022

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