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General NPI Number Information
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NPI Number | 1801062518
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Entity Type | Organization
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Legal Business Name | GRAYSON HOME HEALTH, INC.
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 1305 N 16TH AVE
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City | DURANT
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State | OK
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Zip | 74701-2134
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Country | US
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Telephone | 580-745-9470
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Fax | 580-745-9288
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Provider Business Mailing Address
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Address Line | 1305 N 16TH AVE
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City | DURANT
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State | OK
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Zip | 74701-2134
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Country | US
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Telephone | 580-745-9470
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Fax | 580-745-9288
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Authorized Official
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Title or Position | OWNER
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Name | MS. KELLY D SEXTON
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Credential | LVN
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Telephone | 580-745-9470
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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 | HC7877
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License Number State | OK
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