Autumn Wood Opco, Llc

NPI 1184059982 - Alzheimer Center (Dementia Center) - 311500000X

NPI Details
NPI 1184059982
Enumeration Date 09/11/2013
Last Updated 01/28/2014
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name MATHEW THOMAS MATHEW
Position ADMINISTRATOR
Phone (918) 283-4949
Fax (918) 283-4508
Practice Location
2700 HICKORY ST
CLAREMORE OK, 74017-1214, US
Phone (918) 283-4949
Fax (918) 283-4508
Business Location
PO BOX 1204
CLAREMORE OK, 74018-1204, US
Phone (918) 283-4949
Fax (918) 283-4508
Toxanomy
Taxonomy Code 311500000X
License State Oklahoma
License Number NH6609
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According to our database, Autumn Wood Opco, Llc NPI is 1184059982, taxonomy code is 311500000X and license number is NH6609, license state is located at Oklahoma. Autumn Wood Opco, Llc physically located at 2700 Hickory St, Claremore OK, 74017-1214. NPI Number 1033115704 has the healthcare provider type.

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1184059982 NPI number is provided on an as is basis without warranty of any kind. 1184059982 is maintained by the National Plan & Provider Enumeration System. The contents of Autumn Wood Opco, Llc are for informational purposes only.