MEDICARE: IMPRESSIONS HOME HEALTH CARE

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	251E00000X	Home Health Agency	7769	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417030446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPRESSIONS HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	2525 NW EXPRESSWAY ST
Second Line	:	#337
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7203
Country	:	US
Telephone Number	:	405-607-2302
Fax Number	:	405-607-0310

Provider Business Practice Location Address
First Line	:	2525 NW EXPRESSWAY ST
Second Line	:	#337
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7203
Country	:	US
Telephone Number	:	405-607-2302
Fax Number	:	405-607-0310

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ROBIN WILLIAMSON
Credential	:
Telephone Number	:	405-607-2302

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	03/11/2009

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Directions to “IMPRESSIONS HOME HEALTH CARE ” Practice Location

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