Provider Demographics
NPI:1114181831
Name:OKLAHOMA ASSISTED LIVING, LTD.
Entity Type:Organization
Organization Name:OKLAHOMA ASSISTED LIVING, LTD.
Other - Org Name:HEARTHSTONE AT QUAIL SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-362-3592
Mailing Address - Street 1:14300 N PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-4030
Mailing Address - Country:US
Mailing Address - Phone:405-755-6469
Mailing Address - Fax:405-755-6474
Practice Address - Street 1:14300 N PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-4030
Practice Address - Country:US
Practice Address - Phone:405-755-6469
Practice Address - Fax:405-755-6474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAL-5514-5514310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility