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General NPI Number Information
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NPI Number | 1356823751
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Entity Type | Organization
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Legal Business Name | 24 OUR CARE LLC
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Dates
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Enumeration Date | 08/31/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 15594 OVERLOOK DR
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City | SKIATOOK
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State | OK
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Zip | 74070
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Country | US
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Telephone | 918-633-3144
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Fax |
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Provider Business Mailing Address
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Address Line | 15594 OVERLOOK DR
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City | SKIATOOK
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State | OK
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Zip | 74070-5483
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | FUNG WAH CHRIS RUIZ
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Credential | BSN
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Telephone | 626-321-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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