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Organization
ABRIGHTERLIGHTRESDIENTIAL CARE HOME LLC
Active
Organization
ABRIGHTERLIGHTRESDIENTIAL CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTI LYNN BIRGE (OWNER/ADMINISTOR)
(918) 378-5686
Entity
Organization
Contact information
Practice address
2708 S HEMLOCK AVE, BROKEN ARROW, OK 74012-0817
(918) 378-5686
(918) 286-1404
Mailing address
2708 S HEMLOCK AVE, BROKEN ARROW, OK 74012-0817
(918) 378-5686
(918) 286-1404
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
RC7276
OK
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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