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General NPI Number Information
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NPI Number | 1992448740
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Entity Type | Organization
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Legal Business Name | 2ND HOME ADULT DAYCARE, LLC
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 2006 W WILLOW RD
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City | ENID
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State | OK
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Zip | 73703-2401
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Country | US
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Telephone | 580-297-4034
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Fax | 580-324-6245
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Provider Business Mailing Address
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Address Line | 2006 W WILLOW RD
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City | ENID
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State | OK
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Zip | 73703-2401
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Country | US
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Telephone | 580-297-4034
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Fax | 580-324-6245
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Authorized Official
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Title or Position | OWNER
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Name | KAREN J WOMACK
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Credential | LCSW
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Telephone | 479-494-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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