Evergreen Ok Hts Support
NPI #1255459392 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1255459392
- Entity Type
- Organization
- Organization Name
- Evergreen Ok Hts 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
- City
- Oklahoma City
- State
- Oklahoma
- 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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