Organization
GREENBRIER VILLAGE ADULT DAY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMAN F HACKETT (OWNER)
(580) 233-0121
Entity
Organization
Contact information
Practice address
1217 E OWEN K GARRIOTT RD, SUITE 216, ENID, OK 73701-6235
(580) 234-5827
Mailing address
1217 E OWEN K GARRIOTT RD, SUITE 216, ENID, OK 73701-6235
(580) 234-5827
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
DC2404-2404
OK
Other
Enumeration date
05/22/2007
Last updated
08/22/2020
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