Healthcare Provider Details

I. General information

NPI: 1871610709
Provider Name (Legal Business Name): ST. ANN'S HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 SAINT ANN DR
OKLAHOMA CITY OK
73162-6400
US

IV. Provider business mailing address

9400 SAINT ANN DR
OKLAHOMA CITY OK
73162-6400
US

V. Phone/Fax

Practice location:
  • Phone: 405-728-7888
  • Fax: 405-728-1302
Mailing address:
  • Phone: 405-728-7888
  • Fax: 405-728-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH55295529
License Number StateOK

VIII. Authorized Official

Name: MRS. DOROTHY MARIE JOYCE
Title or Position: ADMINISTRATOR
Credential:
Phone: 405-728-7888