Provider Demographics
NPI:1790884120
Name:ALLEN BOWDEN SCHOOL
Entity Type:Organization
Organization Name:ALLEN BOWDEN SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N.
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCLIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-224-4440
Mailing Address - Street 1:7049 FRANKOMA RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74131-2018
Mailing Address - Country:US
Mailing Address - Phone:918-224-4440
Mailing Address - Fax:918-224-0617
Practice Address - Street 1:7049 FRANKOMA RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74131-2018
Practice Address - Country:US
Practice Address - Phone:918-224-4440
Practice Address - Fax:918-224-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0042052251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100632780AMedicaid