Organization
SANTA FE CHEYENNE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM FORREST WHITE (MANAGING MEMBER)
(405) 634-8888
Entity
Organization
Contact information
Practice address
1000B S SANTA FE AVE, MOORE, OK 73160-2469
(405) 793-1643
(405) 793-1675
Mailing address
1000B S SANTA FE AVE, MOORE, OK 73160-2469
(405) 793-1643
(405) 793-1675
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH1415
OK
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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