PHOENIX HEALTH CARE LLC
Alzheimer Center
Oklahoma City, Oklahoma
Provider NPI: 1972518835
Organization Information:Organization Name: PHOENIX HEALTH CARE LLC
Practice Location:
225 SW 35TH ST OKLAHOMA CITY, OK 73109 US
Tel: 405-631-7444 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
225 SW 35TH ST OKLAHOMA CITY, OK 73109 US
Tel: 405-631-7444 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | OK | NH5534-5534 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
200040930C | OK | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin