Provider Demographics
NPI:1336445451
Name:CARE PLUS HEALTH PROVIDERS LLC
Entity Type:Organization
Organization Name:CARE PLUS HEALTH PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:KAHLILA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:OTD,OTR/L,CEAS
Authorized Official - Phone:405-761-7740
Mailing Address - Street 1:PO BOX 2297
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74821-2297
Mailing Address - Country:US
Mailing Address - Phone:405-761-7740
Mailing Address - Fax:580-421-9491
Practice Address - Street 1:522 W 16TH ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-7610
Practice Address - Country:US
Practice Address - Phone:405-761-7740
Practice Address - Fax:580-421-9491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1433225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty