Healthcare Provider Details

I. General information

NPI: 1346333515
Provider Name (Legal Business Name): OAK VIEW HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 EAST CHOCTAW STREET
SALLISAW OK
74955-0429
US

IV. Provider business mailing address

PO BOX 429
SALLISAW OK
74955-0429
US

V. Phone/Fax

Practice location:
  • Phone: 918-775-4439
  • Fax: 918-775-9242
Mailing address:
  • Phone: 918-775-4439
  • Fax: 918-775-9242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number7496
License Number StateOK

VIII. Authorized Official

Name: MR. KEVIN DOUGLAS MORAN
Title or Position: BUSINESS MANAGEMENT
Credential:
Phone: 918-775-4439