Provider Demographics
NPI:1376860551
Name:SAFY OF OKLAHOMA - LAWTON
Entity Type:Organization
Organization Name:SAFY OF OKLAHOMA - LAWTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPA SENIOR VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-695-8010
Mailing Address - Street 1:1320 NW HOMESTEAD DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5243
Mailing Address - Country:US
Mailing Address - Phone:580-355-8883
Mailing Address - Fax:580-355-8885
Practice Address - Street 1:1320 NW HOMESTEAD DR
Practice Address - Street 2:SUITE G
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5243
Practice Address - Country:US
Practice Address - Phone:580-355-8883
Practice Address - Fax:580-355-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency