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NPI Code Detail

MEDICARE: NATIONAL COMMUNITY DEV CORP OF OK

MEDICARE: NATIONAL COMMUNITY DEV CORP OF OK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1053512251
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONAL COMMUNITY DEV CORP OF OK
Provider Business Mailing Address
First Line : 45 HARRISON AVE
Second Line : OA
City : BRANFORD
State : CT
Zip : 06405-3787
Country : US
Telephone Number : 203-483-1670
Fax Number : 203-483-1676
Provider Business Practice Location Address
First Line : 1516 SO BOSTON
Second Line : SUITE ONE
City : TULSA
State : OK
Zip : 74119-4029
Country : US
Telephone Number : 918-585-2233
Fax Number : 918-585-2513
Authorized Official
Title or Position : VP FINANCE
Name : CAROLYN F VARONE
Credential :
Telephone Number : 203-483-1670
Provider Enumeration Date : 05/29/2007
Last Update Date : 07/26/2007

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Directions to “NATIONAL COMMUNITY DEV CORP OF OK ” Practice Location

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