Organization
FAITH 7 ACTIVITY CENTER
Active
Organization
FAITH 7 ACTIVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L PYEATT (DIRECTOR)
(405) 275-4223
Entity
Organization
Contact information
Practice address
301 S KENNEDY AVE, SHAWNEE, OK 74801-7613
(405) 275-4223
(405) 273-2994
Mailing address
301 S KENNEDY AVE, SHAWNEE, OK 74801-7613
(405) 275-4223
(405) 273-2994
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100632930A
DDSD WAIVER
OK
01
—
100632930B
DDSD WAIVER
OK
01
—
100632930E
DDSD WAIVER
OK
01
—
100632930F
DDSD WAIVER
OK
Enumeration date
01/31/2007
Last updated
05/29/2008
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