Provider Demographics
NPI:1629248000
Name:ULTIMATE HOME CARE LLC, DBA OAK VIEW HELATH SERVICES
Entity Type:Organization
Organization Name:ULTIMATE HOME CARE LLC, DBA OAK VIEW HELATH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-286-2664
Mailing Address - Street 1:2310 S CENTRAL
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-7916
Mailing Address - Country:US
Mailing Address - Phone:580-286-2664
Mailing Address - Fax:
Practice Address - Street 1:2310 S CENTRAL
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-7916
Practice Address - Country:US
Practice Address - Phone:580-286-2664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7496314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility