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General NPI Number Information
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NPI Number | 1093852014
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Entity Type | Organization
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Legal Business Name | RELIANT LIVING CENTERS OF OKLAHOMA, INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2901 SE 22ND ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73129-8413
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Country | US
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Telephone | 405-677-2421
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Fax | 405-677-2487
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Provider Business Mailing Address
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Address Line | 2901 SE 22ND ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73129-8413
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Country | US
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Telephone | 405-677-2421
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Fax | 405-677-2487
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BILL J FLORENCE
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Credential | ADMINISTRATOR
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Telephone | 405-677-2421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH5565
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License Number State | OK
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