Provider Demographics
NPI:1952456931
Name:ALLFAITH HOMECARE
Entity Type:Organization
Organization Name:ALLFAITH HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BENSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-340-5100
Mailing Address - Street 1:3500 S BOULEVARD
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5486
Mailing Address - Country:US
Mailing Address - Phone:405-340-5100
Mailing Address - Fax:405-340-5109
Practice Address - Street 1:3500 S BOULEVARD
Practice Address - Street 2:SUITE A-2
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5486
Practice Address - Country:US
Practice Address - Phone:405-340-5100
Practice Address - Fax:405-340-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7626251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
377625Medicare ID - Type Unspecified