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Organization

LIBERTY OF OKLAHOMA CORPORATION

Active
Parent organization
LIBERTY OF OKLAHOMA CORPORATION
Other names
Laura Dester Children's Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
LIBERTY OF OKLAHOMA CORPORATION
Authorized official
HUGH M. SAGE PHD (CHIEF EXECUTIVE OFFICER)
(580) 213-2782
Entity
Organization

Contact information

Practice address
7318 E PINE ST, TULSA, OK 74115-5743
(539) 292-4607
Mailing address
7318 E PINE ST, TULSA, OK 74115-5743
(539) 292-4607

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NH7255-7255
OK
Enumeration date
04/09/2019
Last updated
04/09/2019
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