Provider Demographics
NPI:1508149105
Name:VISITING ANGELS, LIVING ASSISTANCE SERVICES
Entity Type:Organization
Organization Name:VISITING ANGELS, LIVING ASSISTANCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RENE'
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-350-6700
Mailing Address - Street 1:PO BOX 850560
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73085-0560
Mailing Address - Country:US
Mailing Address - Phone:405-350-6700
Mailing Address - Fax:405-354-0541
Practice Address - Street 1:713 S MUSTANG RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6778
Practice Address - Country:US
Practice Address - Phone:405-350-6700
Practice Address - Fax:405-354-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7854251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health