Provider Demographics
NPI:1427019710
Name:ALLIED HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ALLIED HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-693-8748
Mailing Address - Street 1:1619 S. PEORIA AVE.
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120
Mailing Address - Country:US
Mailing Address - Phone:918-742-4269
Mailing Address - Fax:918-742-4493
Practice Address - Street 1:1619 S. PEORIA AVE.
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120
Practice Address - Country:US
Practice Address - Phone:918-742-4269
Practice Address - Fax:918-742-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7088251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
377437Medicare ID - Type Unspecified