Provider Demographics
NPI:1821188723
Name:LIFECARE OKLAHOMA HOSPICE, INC.
Entity Type:Organization
Organization Name:LIFECARE OKLAHOMA HOSPICE, INC.
Other - Org Name:LIFESPRING HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:VAHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-329-2290
Mailing Address - Street 1:2411 SPRINGER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3955
Mailing Address - Country:US
Mailing Address - Phone:405-329-2290
Mailing Address - Fax:405-310-3371
Practice Address - Street 1:2411 SPRINGER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3955
Practice Address - Country:US
Practice Address - Phone:405-329-2290
Practice Address - Fax:405-310-3371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37-1681Medicare PIN