Provider Demographics
NPI:1578840302
Name:DYNASTY CARE SERVICES, LLC
Entity Type:Organization
Organization Name:DYNASTY CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:CM, BHRS
Authorized Official - Phone:405-406-7216
Mailing Address - Street 1:4337 SE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-3001
Mailing Address - Country:US
Mailing Address - Phone:405-609-1760
Mailing Address - Fax:405-609-1769
Practice Address - Street 1:4337 SE 15TH ST
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3001
Practice Address - Country:US
Practice Address - Phone:405-609-1760
Practice Address - Fax:405-609-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care