Organization
GREEN COUNTRY REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI LYNN- HARRIS DAVIS COTA/L (COTA/L)
(405) 517-8198
Entity
Organization
Contact information
Practice address
3535 NW 58TH ST STE 940, OKLAHOMA CITY, OK 73112-4802
(405) 605-1130
(405) 605-1402
Mailing address
3535 NW 58TH ST STE 940, OKLAHOMA CITY, OK 73112-4802
(405) 605-1130
(405) 605-1402
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
597
OK
310400000X
Assisted Living Facility
597
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9239
ALL INSURANCE
OK
Enumeration date
11/24/2014
Last updated
11/24/2014
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