Provider Demographics
NPI:1053512251
Name:NATIONAL COMMUNITY DEV CORP OF OK
Entity Type:Organization
Organization Name:NATIONAL COMMUNITY DEV CORP OF OK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:F
Authorized Official - Last Name:VARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-483-1670
Mailing Address - Street 1:45 HARRISON AVE
Mailing Address - Street 2:OA
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3787
Mailing Address - Country:US
Mailing Address - Phone:203-483-1670
Mailing Address - Fax:203-483-1676
Practice Address - Street 1:1516 SO BOSTON
Practice Address - Street 2:SUITE ONE
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4029
Practice Address - Country:US
Practice Address - Phone:918-585-2233
Practice Address - Fax:918-585-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities