institution
Evergreen Ok Companion Support
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oklahoma City, Oklahoma
NPI 1740308857

Evergreen Ok Companion Support is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Haughton, OK. Evergreen Ok Companion Support practices in Oklahoma City, OK. The NPI Number for Evergreen Ok Companion Support is 1740308857 and holds a License No. (Oklahoma).

The current practice location address for Evergreen Ok Companion Support is 7725 W Britton Rd, Oklahoma City, OK and can be reached out via phone at 405-720-1192 and via fax at 405-720-1193.

Location: 7725 W Britton Rd, Oklahoma City, OK, 71037-9488
institution
Provider Profile Details
NPI Number
1740308857
Provider Name
Evergreen Ok Companion Support
Credential
Provider Entity Type
Organization
Address
7725 W Britton Rd, Oklahoma City, OK, 71037-9488
Phone Number
405-720-1192
Fax Number
405-720-1193
Provider Enumeration Date
03/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100645750G-G620 05 OK
institution
Provider Business Practice Location Address Details
Address
7725 W Britton Rd
City
State
Zip
73132-1507
Phone Number
405-720-1192
Fax Number
405-720-1193
person
Provider Business Mailing Address Details
Address
7725 W Britton Rd
City
State
Zip
73132-1507
Phone Number
405-720-1192
Fax Number
405-720-1193
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.
()
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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