Healthcare Provider Details

I. General information

NPI: 1740600436
Provider Name (Legal Business Name): COMMUNITY ACCESS, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2014
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 SE 36TH ST
LAWTON OK
73501-8458
US

IV. Provider business mailing address

PO BOX 154
LAWTON OK
73502-0154
US

V. Phone/Fax

Practice location:
  • Phone: 580-353-2045
  • Fax: 580-353-6470
Mailing address:
  • Phone: 580-353-2045
  • Fax: 580-353-6470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DONA E. SPANGLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 580-353-2045