Organization
DUNCAN COMMUNITY RESIDENCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN D WOLFF (ADMINISTRATOR)
(580) 255-3926
Entity
Organization
Contact information
Practice address
1510 W MAIN ST, DUNCAN, OK 73533-4333
(580) 255-3926
(580) 255-8877
Mailing address
PO BOX 1474, 1510 W. MAIN, DUNCAN, OK 73534-1474
(580) 255-3926
(580) 255-8877
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
RC6901-6901
OK
320800000X
Mental Illness Community Based Residential Treatment Facility
RC6901-6901
OK
Other
Enumeration date
04/11/2007
Last updated
11/16/2009
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