Provider Demographics
NPI:1932516168
Name:CHH OK, LLC
Entity Type:Organization
Organization Name:CHH OK, LLC
Other - Org Name:CLEVELAND HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENICE
Authorized Official - Middle Name:DEROIN
Authorized Official - Last Name:ACOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-358-2483
Mailing Address - Street 1:1310 W PAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020-3018
Mailing Address - Country:US
Mailing Address - Phone:918-358-2483
Mailing Address - Fax:918-358-2641
Practice Address - Street 1:1310 W PAWNEE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OK
Practice Address - Zip Code:74020-3018
Practice Address - Country:US
Practice Address - Phone:918-358-2483
Practice Address - Fax:918-358-2641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7167251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377138Medicare UPIN