# GRAND VILLAGE IN HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972151967
- **Authorized official:** SHALEITHA COLLINS LPN (OWNER)
- **Authorized official phone:** (405) 821-1806

## Contact information

- **Practice address:** 1320 N ROCKWELL AVE APT B, OKLAHOMA CITY, OK 73127-3355
- **Practice address phone:** (405) 821-1806
- **Mailing address:** 1320 N ROCKWELL AVE APT B, OKLAHOMA CITY, OK 73127-3355
- **Mailing address phone:** (405) 821-1806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/03/2019
- **Last updated:** 09/03/2019