Provider Demographics
NPI:1336654680
Name:PREFERRED FAMILY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:PREFERRED FAMILY HEALTH CARE, INC.
Other - Org Name:DAYSPRING COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CONOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-224-1210
Mailing Address - Street 1:3015 E SKELLY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6344
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 E STEVE OWENS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-7800
Practice Address - Country:US
Practice Address - Phone:918-544-6080
Practice Address - Fax:918-544-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)