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General NPI Number Information
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NPI Number | 1225094014
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Entity Type | Organization
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Legal Business Name | ACCENTRA HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1515 S 7TH ST STE 400
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City | KINGFISHER
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State | OK
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Zip | 73750-4318
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Country | US
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Telephone | 405-375-6488
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Fax | 405-283-4075
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Provider Business Mailing Address
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Address Line | 6760 OLD JACKSONVILLE HWY STE 101
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City | TYLER
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State | TX
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Zip | 75703-0566
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Country | US
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Telephone | 855-485-8273
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | KATRINA DAWN LANIER
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Credential |
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Telephone | 855-485-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7734
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License Number State | OK
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