Organization
PETERS AGENCY HOME CARE, LLC
Active
Other names
Peters Agency Provider Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRUDY A PETERS MBA, RN, CCM, LHCA (CEO)
(918) 775-6555
Entity
Organization
Contact information
Practice address
1015 EAST CHOCTAW AVENUE, SALLISAW, OK 74955-5011
(918) 790-7555
(918) 790-7587
Mailing address
1015 EAST CHOCTAW AVENUE, SALLISAW, OK 74955-5011
(918) 790-7555
(918) 790-7587
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
7891
OK
253Z00000X
In Home Supportive Care Agency
Primary
7891
OK
3747P1801X
Personal Care Attendant
7891
OK
376J00000X
Homemaker
7891
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200202440
—
OK
Enumeration date
12/07/2009
Last updated
06/10/2010
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