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General NPI Number Information
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NPI Number | 1336503606
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE ADULT DAY CENTER, INC
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 1304 E. LINDSEY PLAZA DRIVE
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City | NORMAN
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State | OK
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Zip | 73071
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Country | US
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Telephone | 405-447-2955
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Fax | 405-701-0546
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Provider Business Mailing Address
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Address Line | 1304 E. LINDSEY PLAZA DRIVE
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City | NORMAN
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State | OK
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Zip | 73071
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Country | US
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Telephone | 405-447-2955
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Fax | 405-701-0546
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. PATRICIA L. INGRAM
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Credential |
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Telephone | 405-447-2955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | DC1401-1401
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License Number State | OK
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