Organization
WOVENLIFE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA KRISTIN PORTER (PRESIDENT & CEO)
(405) 239-2525
Entity
Organization
Contact information
Practice address
701 NE 13TH ST, OKLAHOMA CITY, OK 73104-5003
(405) 239-2525
(405) 239-2278
Mailing address
701 NE 13TH ST, OKLAHOMA CITY, OK 73104-5003
(405) 239-2525
(405) 239-2278
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
DC5512
OK
261QM2500X
Medical Specialty Clinic/Center
—
—
385H00000X
Respite Care
DC5512-5512
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100683310A
—
OK
05
—
100683310B
—
OK
Enumeration date
02/20/2009
Last updated
04/11/2018
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