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General NPI Number Information
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NPI Number | 1801914064
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Entity Type | Organization
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Legal Business Name | UNITED CARE L.L.C.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6701 BROADWAY EXT SUITE 211
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-8237
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Country | US
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Telephone | 405-843-3400
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Fax | 405-843-8800
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Provider Business Mailing Address
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Address Line | 6701 BROADWAY EXT SUITE 211
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-8237
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Country | US
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Telephone | 405-843-3400
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Fax | 405-843-8800
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | CHRISTINE EARLETTA FOGLESONG
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Credential | MSW, LCSW
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Telephone | 405-843-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2970
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License Number State | OK
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