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General NPI Number Information
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NPI Number | 1821360769
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Entity Type | Organization
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Legal Business Name | COMPANION AT HOME, LLC
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 1310 E OKLAHOMA AVE STE B
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City | GUTHRIE
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State | OK
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Zip | 73044-3757
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Country | US
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Telephone | 405-282-1307
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Fax | 405-282-3402
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Provider Business Mailing Address
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Address Line | 1310 E OKLAHOMA AVE STE B
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City | GUTHRIE
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State | OK
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Zip | 73044-3757
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Country | US
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Telephone | 405-282-1307
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Fax | 405-282-3402
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DONNA K BENNETT
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Credential | R.N, CHCA
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Telephone | 405-282-1307
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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 | 7980
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License Number State | OK
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