Jackie Fields Foundation

NPI #1578865317 in Muskogee, Oklahoma

Provider Information

NPI Number: 1578865317
Entity Type: Organization
Organization Name: Jackie Fields Foundation
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 30, 2010
Last Updated: Nov 30, 2010

Practice Location

Address: 2303 PICKENS
City: Muskogee
State: Oklahoma
ZIP Code: 74402
Phone: (918) 913-6017

Authorized Official

Name: JACKIE DEVORAH STANFORD, ADM RESIDENTAL CARE
Title: CEO
Phone: (918) 913-6017

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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