Healthcare Provider Details

I. General information

NPI: 1134214257
Provider Name (Legal Business Name): LIFECARE OKLAHOMA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 SPRINGER DR SUITE 100
NORMAN OK
73069-3955
US

IV. Provider business mailing address

2411 SPRINGER DR SUITE 100
NORMAN OK
73069-3955
US

V. Phone/Fax

Practice location:
  • Phone: 405-329-4545
  • Fax: 405-573-5190
Mailing address:
  • Phone: 405-329-4545
  • Fax: 405-573-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7762
License Number StateOK

VIII. Authorized Official

Name: MS. KAREN ELAINE VAHLBERG
Title or Position: PRESIDENT
Credential: RN
Phone: 405-329-4545