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NPI 1063474765

NPI 1063474765 : OKLAHOMA'S ACTION REHABILITATION CENTERS, INC. : WOODWARD, OK

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General NPI Number Information
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    NPI Number           |    1063474765
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    Entity Type          |    Organization 
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    Legal Business Name  |    OKLAHOMA'S ACTION REHABILITATION CENTERS, INC. 
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Dates
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    Enumeration Date     |    04/06/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    622 8TH ST 
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    City                 |    WOODWARD
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    State                |    OK
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    Zip                  |    73801-1447
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    Country              |    US
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    Telephone            |    580-256-9412
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    Fax                  |    580-256-0633
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Provider Business Mailing Address
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    Address Line         |    622 8TH ST P.O. BOX 158
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    City                 |    WOODWARD
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    State                |    OK
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    Zip                  |    73801-1447
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    Country              |    US
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    Telephone            |    580-256-9412
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    Fax                  |    580-256-0633
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR
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    Name                 |    MR. TERRY DEAN TREGO 
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    Credential           |    
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    Telephone            |    580-256-9412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    320900000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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    License Number       |    
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    License Number State |    OK
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