Healthcare Provider Details

I. General information

NPI: 1861758468
Provider Name (Legal Business Name): HEALTHCARE INNOVATIONS IN-HOME SERVICES OF OKLAHOMA CITY , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 HIGHLINE BLVD SUITE C280
OKLAHOMA CITY OK
73108-1830
US

IV. Provider business mailing address

4300 HIGHLINE BLVD SUITE 380
OKLAHOMA CITY OK
73108-1830
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-9984
  • Fax: 405-949-0121
Mailing address:
  • Phone: 405-949-9984
  • Fax: 405-949-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7611
License Number StateOK

VIII. Authorized Official

Name: MS. CARLA HERRERA
Title or Position: PRESIDENT /ADMINISTARTOR
Credential:
Phone: 903-537-8629