Healthcare Provider Details

I. General information

NPI: 1407197049
Provider Name (Legal Business Name): TRUEVINE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11221 W RENO AVE STE 100
YUKON OK
73099-7569
US

IV. Provider business mailing address

11221 W RENO AVE STE 100
YUKON OK
73099-7569
US

V. Phone/Fax

Practice location:
  • Phone: 405-253-4413
  • Fax: 314-833-3179
Mailing address:
  • Phone: 405-253-4413
  • Fax: 314-833-3179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC8018
License Number StateOK

VIII. Authorized Official

Name: YOSEF MANNE
Title or Position: CEO
Credential:
Phone: 718-612-2183