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General NPI Number Information
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NPI Number | 1609174416
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Entity Type | Organization
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Legal Business Name | ALL ABOUT FAMILY-PRIVATE DUTY SERVICE, INC.
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 106 S 3RD ST
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City | MCALESTER
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State | OK
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Zip | 74501-5300
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Country | US
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Telephone | 918-302-0070
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Fax | 918-302-0073
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Provider Business Mailing Address
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Address Line | 106 S 3RD ST
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City | MCALESTER
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State | OK
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Zip | 74501-5300
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Country | US
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Telephone | 918-302-0070
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Fax | 918-302-0073
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Authorized Official
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Title or Position | OWNER/ADMINSTRATOR
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Name | MR. TERRY LEE NIX JR.
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Credential |
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Telephone | 918-302-0070
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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 | 7953
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License Number State | OK
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