Healthcare Provider Details

I. General information

NPI: 1063474765
Provider Name (Legal Business Name): OKLAHOMA'S ACTION REHABILITATION CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 8TH ST
WOODWARD OK
73801-1447
US

IV. Provider business mailing address

622 8TH ST P.O. BOX 158
WOODWARD OK
73801-1447
US

V. Phone/Fax

Practice location:
  • Phone: 580-256-9412
  • Fax: 580-256-0633
Mailing address:
  • Phone: 580-256-9412
  • Fax: 580-256-0633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateOK

VIII. Authorized Official

Name: MR. TERRY DEAN TREGO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 580-256-9412