Organization
COLUMBIAN HALL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM O'BRIEN SR. (EXECUTIVE DIRECTOR)
(405) 263-4658
Entity
Organization
Contact information
Practice address
6TH AND TEXAS, OKARCHE, OK 73762-0245
(405) 263-4658
(405) 263-4718
Mailing address
PO BOX 245, OKARCHE, OK 73762-0245
(405) 263-4658
(405) 263-4718
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH0911-0911
OK
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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