Provider Demographics
NPI:1407981947
Name:LIVING IMPROVEMENT FOR THE ELDERLY CENTER
Entity Type:Organization
Organization Name:LIVING IMPROVEMENT FOR THE ELDERLY CENTER
Other - Org Name:LIFE ADULT DAY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CTRS
Authorized Official - Phone:405-377-0978
Mailing Address - Street 1:411 W MATHEWS AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-7517
Mailing Address - Country:US
Mailing Address - Phone:405-377-0978
Mailing Address - Fax:405-372-7726
Practice Address - Street 1:411 W MATHEWS AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-7517
Practice Address - Country:US
Practice Address - Phone:405-377-0978
Practice Address - Fax:405-372-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100682960AMedicaid
OK100682960BOtherADULT DAY SERVICES