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Organization
IMPERIAL CONCIERGE CARE
Active
Organization
IMPERIAL CONCIERGE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARTAVIA COOK (ADMINISTRATOR)
(405) 619-8577
Entity
Organization
Contact information
Practice address
6805 LANCER LN, OKLAHOMA CITY, OK 73132-6033
(405) 619-8577
Mailing address
6805 LANCER LN, OKLAHOMA CITY, OK 73132-6033
(405) 619-8577
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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