Healthcare Provider Details

I. General information

NPI: 1508731076
Provider Name (Legal Business Name): RELIANCE SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N GRAND AVE STE 323
OKMULGEE OK
74447-4057
US

IV. Provider business mailing address

114 N GRAND AVE STE 323
OKMULGEE OK
74447-4057
US

V. Phone/Fax

Practice location:
  • Phone: 918-240-7567
  • Fax:
Mailing address:
  • Phone: 918-934-2506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DEAUNDREA D PATTERSON
Title or Position: SUPERVISOR
Credential:
Phone: 918-934-2506