MEDICARE: PAF HOME CARE, LLC

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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164133237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAF HOME CARE, LLC

Provider Business Mailing Address
First Line	:	3844 N MACARTHUR BLVD
Second Line	:
City	:	WARR ACRES
State	:	OK
Zip	:	73122-2016
Country	:	US
Telephone Number	:	405-521-1963
Fax Number	:	405-524-3690

Provider Business Practice Location Address
First Line	:	3844 N MACARTHUR BLVD
Second Line	:
City	:	WARR ACRES
State	:	OK
Zip	:	73122-2016
Country	:	US
Telephone Number	:	405-521-1963
Fax Number	:	405-524-3690

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	HEATHER HENDERSON
Credential	:
Telephone Number	:	501-764-1814

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	12/09/2022

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Directions to “PAF HOME CARE, LLC ” Practice Location

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