Provider Demographics
NPI:1710985080
Name:CHEROKEE NATION HOME HEALTH OUTREACH
Entity Type:Organization
Organization Name:CHEROKEE NATION HOME HEALTH OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-456-5051
Mailing Address - Street 1:1630 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-6755
Mailing Address - Country:US
Mailing Address - Phone:918-456-5051
Mailing Address - Fax:918-456-1120
Practice Address - Street 1:1630 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-6755
Practice Address - Country:US
Practice Address - Phone:918-456-5051
Practice Address - Fax:918-456-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7671251B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies