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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

Other

Enumeration date
10/07/2019
Last updated
10/07/2019
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