institution
Dungarvin Oklahoma Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oklahoma City, Oklahoma
NPI 1174698849

Dungarvin Oklahoma Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Mendota Heights, OK. Dungarvin Oklahoma Llc practices in Oklahoma City, OK. The NPI Number for Dungarvin Oklahoma Llc is 1174698849 and holds a License No. 100631340F (Oklahoma).

The current practice location address for Dungarvin Oklahoma Llc is 9210 S Western Ave Ste A-22, Oklahoma City, OK and can be reached out via phone at 405-759-2611 and via fax at 405-759-2650. You can also correspond with Dungarvin Oklahoma Llc through the mailing address at 1444 NORTHLAND DR STE 200, MENDOTA HEIGHTS, MN - 55120-1032 (mailing address contact number: 651-699-0206).

Location: 9210 S Western Ave Ste A-22, Oklahoma City, OK, 55120-1032
institution
Provider Profile Details
NPI Number
1174698849
Provider Name
Dungarvin Oklahoma Llc
Credential
Provider Entity Type
Organization
Address
9210 S Western Ave Ste A-22, Oklahoma City, OK, 55120-1032
Phone Number
405-759-2611
Fax Number
405-759-2650
Provider Enumeration Date
11/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100631340F 01 OK OHCA PROVIDER ID
institution
Provider Business Practice Location Address Details
Address
9210 S Western Ave Ste A-22
City
State
Zip
73139-4982
Phone Number
405-759-2611
Fax Number
405-759-2650
person
Provider Business Mailing Address Details
Address
9210 S Western Ave Ste A-22
City
State
Zip
73139-4982
Phone Number
405-759-2611
Fax Number
405-759-2650
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
100631340F (Oklahoma)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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