Healthcare Provider Details

I. General information

NPI: 1770404493
Provider Name (Legal Business Name): HEROES HOME HEALTH OK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

508 W VANDAMENT AVE
YUKON OK
73099-4655
US

IV. Provider business mailing address

508 W VANDAMENT AVE
YUKON OK
73099-4655
US

V. Phone/Fax

Practice location:
  • Phone: 806-420-0012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIM DYSON MAY
Title or Position: CEO/OWNER
Credential:
Phone: 806-420-0012