Provider Demographics
NPI:1144388547
Name:GREATER DIMENSIONS HEALTH AGENCY
Entity Type:Organization
Organization Name:GREATER DIMENSIONS HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATRINA
Authorized Official - Middle Name:DION
Authorized Official - Last Name:BENJAMIN-FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-386-7964
Mailing Address - Street 1:7812 DRIPPING SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73150-8326
Mailing Address - Country:US
Mailing Address - Phone:405-386-7964
Mailing Address - Fax:
Practice Address - Street 1:7812 DRIPPING SPRINGS LN
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73150-8326
Practice Address - Country:US
Practice Address - Phone:405-386-7964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
Not Answered171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Not Answered374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Not Answered376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty