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General NPI Number Information
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NPI Number | 1114181831
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Entity Type | Organization
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Legal Business Name | OKLAHOMA ASSISTED LIVING, LTD.
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 14300 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-4030
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Country | US
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Telephone | 405-755-6469
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Fax | 405-755-6474
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Provider Business Mailing Address
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Address Line | 14300 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-4030
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Country | US
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Telephone | 405-755-6469
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Fax | 405-755-6474
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Authorized Official
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Title or Position | VP/CONTROLLER
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Name | LIZ VARGAS
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Credential |
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Telephone | 281-362-3592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL-5514-5514
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License Number State | OK
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