Healthcare Provider Details

I. General information

NPI: 1275558280
Provider Name (Legal Business Name): LIFESPRING HOME CARE OF SAYRE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E MAIN ST
SAYRE OK
73662-2916
US

IV. Provider business mailing address

2411 SPRINGER DR
NORMAN OK
73069-3955
US

V. Phone/Fax

Practice location:
  • Phone: 580-928-2275
  • Fax: 580-928-4475
Mailing address:
  • Phone: 405-329-4545
  • Fax: 405-310-3371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7321
License Number StateOK

VIII. Authorized Official

Name: KAREN E VAHLBERG
Title or Position: CEO
Credential:
Phone: 405-329-4545