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General NPI Number Information
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NPI Number | 1770638157
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Entity Type | Organization
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Legal Business Name | CLEVELAND AREA HOSPITAL HOME HEALTH
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 901 N BROADWAY ST
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City | CLEVELAND
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State | OK
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Zip | 74020-1205
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Country | US
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Telephone | 918-358-2483
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Fax | 918-358-2641
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Provider Business Mailing Address
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Address Line | 901 N BROADWAY ST
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City | CLEVELAND
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State | OK
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Zip | 74020-1205
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Country | US
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Telephone | 918-358-2483
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Fax | 918-358-2641
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DEBORAH LYNNE STITH
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Credential | RN
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Telephone | 918-358-2483
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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 | 7167
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License Number State | OK
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