Healthcare Provider Details

I. General information

NPI: 1326194150
Provider Name (Legal Business Name): OKLAHOMA ASSOCIATION FOR RETARDED CITIZENS CARTER COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 3RD AVENUE SOUTH WEST
ARDMORE OK
73401-1944
US

IV. Provider business mailing address

108 3RD AVENUE SOUTH WEST
ARDMORE OK
73401-1944
US

V. Phone/Fax

Practice location:
  • Phone: 580-226-3580
  • Fax: 580-226-3458
Mailing address:
  • Phone: 580-226-3580
  • Fax: 580-226-3458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA SUE DRUMMOND
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 580-226-3580