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General NPI Number Information
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NPI Number | 1235583584
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Entity Type | Organization
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Legal Business Name | GARVIN COUNTY COMMUNITY LIVING CENTER, INC
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 421 N CHERRY ST
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City | PAULS VALLEY
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State | OK
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Zip | 73075-2607
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Country | US
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Telephone | 405-238-3773
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Fax | 405-238-7730
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Provider Business Mailing Address
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Address Line | PO BOX 1119 1800 ENTERPRISE BLVD
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City | PAULS VALLEY
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State | OK
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Zip | 73075-1119
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Country | US
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Telephone | 405-238-3773
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Fax | 405-238-7730
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Authorized Official
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Title or Position | CEO
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Name | CATHY CASH
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Credential |
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Telephone | 405-238-3773
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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 |
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License Number State |
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