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General NPI Number Information
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NPI Number | 1982947172
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Entity Type | Organization
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Legal Business Name | SPANISH COVE HOUSING AUTHORITY
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 11 PALM AVE
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City | YUKON
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State | OK
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Zip | 73099-5645
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Country | US
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Telephone | 405-354-1901
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Fax | 405-354-6584
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Provider Business Mailing Address
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Address Line | 11 PALM AVE
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City | YUKON
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State | OK
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Zip | 73099-5645
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Country | US
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Telephone | 405-354-1901
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Fax | 405-354-6584
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Authorized Official
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Title or Position | CEO & EXECUTIVE ADMINISTRATOR
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Name | DONALD N. BLOSE
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Credential |
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Telephone | 405-354-1901
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | CC0901-0901
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License Number State | OK
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