Healthcare Provider Details

I. General information

NPI: 1922334275
Provider Name (Legal Business Name): AFT HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W 15TH STREET SUITE #5
EDMOND OK
73013-3641
US

IV. Provider business mailing address

700 W 15TH SUITE #5
EDMOND OK
73013-3641
US

V. Phone/Fax

Practice location:
  • Phone: 405-227-9899
  • Fax: 405-246-9276
Mailing address:
  • Phone: 405-227-9899
  • Fax: 405-246-9276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA-37V753020608
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberCNA-37V753010608
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-52156
License Number StateOK

VIII. Authorized Official

Name: MRS. SARAH RICHARDSON
Title or Position: DIRECTOR
Credential: CNA & HHA (OKLAHOMA)
Phone: 405-227-9899