Healthcare Provider Details

I. General information

NPI: 1831336189
Provider Name (Legal Business Name): SUNNY DAYS ADULT DAYCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PECAN ST
PAULS VALLEY OK
73075-5049
US

IV. Provider business mailing address

700 S PECAN ST
PAULS VALLEY OK
73075-5049
US

V. Phone/Fax

Practice location:
  • Phone: 405-238-2224
  • Fax:
Mailing address:
  • Phone: 405-238-2224
  • Fax: 405-238-2224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA J RIDGEWAY
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 405-238-2224