MEDICARE: 2ND HOME ADULT DAYCARE, 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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1992448740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	2ND HOME ADULT DAYCARE, LLC

Provider Business Mailing Address
First Line	:	2425 N GRAND ST
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73701-1534
Country	:	US
Telephone Number	:	580-297-4034
Fax Number	:	580-324-6245

Provider Business Practice Location Address
First Line	:	2425 N GRAND ST
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73701-1534
Country	:	US
Telephone Number	:	580-297-4034
Fax Number	:	580-324-6245

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN J WOMACK
Credential	:
Telephone Number	:	580-297-4034

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	03/16/2026

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