Provider Demographics
NPI:1245431378
Name:ASSURANCE HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ASSURANCE HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-584-9109
Mailing Address - Street 1:4519 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:OK
Mailing Address - Zip Code:74728-5999
Mailing Address - Country:US
Mailing Address - Phone:580-584-9109
Mailing Address - Fax:580-584-9110
Practice Address - Street 1:4519 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:OK
Practice Address - Zip Code:74728-5999
Practice Address - Country:US
Practice Address - Phone:580-584-9109
Practice Address - Fax:580-584-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7850251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200223300AMedicaid