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General NPI Number Information
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NPI Number | 1659531887
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Entity Type | Organization
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Legal Business Name | TAD INVESTMENTS
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 35164 S 4465 RD
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City | VINITA
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State | OK
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Zip | 74301-6782
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Country | US
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Telephone | 918-782-9370
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Fax |
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Provider Business Mailing Address
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Address Line | 35164 S 4465 RD
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City | VINITA
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State | OK
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Zip | 74301-6782
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Country | US
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Telephone | 918-782-9370
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMER
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Name | MR. DANDY A RISMAN
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Credential |
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Telephone | 918-782-9370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | RC4904-4904
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License Number State | OK
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