Evergreen Ok Room & Board Support

NPI #1184742231 in Oklahoma City, Oklahoma

Provider Information

NPI Number
1184742231
Entity Type
Organization
Organization Name
Evergreen Ok Room & Board Support
Primary Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Mar 27, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
7725 W BRITTON RD
ZIP Code
73132-1507
Phone
(405) 720-1192

Authorized Official

Name
JOHN R TAYLOR
Title
PRESIDENT
Phone
(318) 742-8440

Specialties & Taxonomy Codes

Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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