Abrighterlightresdiential Care Home LLC

NPI #1073994596 in Broken Arrow, Oklahoma

Provider Information

NPI Number: 1073994596
Entity Type: Organization
Organization Name: Abrighterlightresdiential Care Home LLC
Primary Specialty: Residential Treatment Facility, Physical Disabilities
Enumeration Date: Jun 10, 2015
Last Updated: Jun 10, 2015

Practice Location

Address: 2708 S HEMLOCK AVE
City: Broken Arrow
State: Oklahoma
ZIP Code: 74012-0817
Phone: (918) 378-5686

Authorized Official

Name: PATTI LYNN BIRGE
Title: OWNER/ADMINISTOR
Phone: (918) 378-5686

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Physical Disabilities	320700000X	Primary

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