Healthcare Provider Details
I. General information
NPI: 1134056526
Provider Name (Legal Business Name): COTTONWOOD CAPITAL LLC DBA SENIOR HELPERS OF SOUTHCENTRAL OKLAHOMA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
114 THOMPSON DR
NORMAN OK
73069-5245
US
IV. Provider business mailing address
114 THOMPSON DR
NORMAN OK
73069-5245
US
V. Phone/Fax
- Phone: 405-310-0036
- Fax:
- Phone: 405-310-0036
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RYAN
RUSS
Title or Position: OWNER
Credential:
Phone: 405-306-6281