Organization
DUNGARVIN OKLAHOMA LLC
Active
Parent organization
DUNGARVIN GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
DUNGARVIN GROUP, INC.
Authorized official
LORI KRESS (CEO)
(651) 699-0206
Entity
Organization
Contact information
Practice address
9210 S WESTERN AVE STE A-22, OKLAHOMA CITY, OK 73139-4982
(405) 759-2611
(405) 759-2650
Mailing address
1444 NORTHLAND DR STE 200, MENDOTA HEIGHTS, MN 55120-1032
(651) 699-0206
(651) 699-0799
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
100631340G
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100631340G
OHCA PROVIDER ID
OK
Enumeration date
11/21/2006
Last updated
04/27/2023
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