Organization
FAIRCHILD HOME AND COMMUNITY BASED SERVICES, LLC
Active
Other names
Albert Hall
Organization subpart
No
Provider details
NPI number
Authorized official
CONSUELA F LOGAN QIDP (ADMINISTRATOR)
(580) 725-3400
Entity
Organization
Contact information
Practice address
205 E MAPLE, BILLINGS, OK 74630
(580) 725-3400
(580) 725-3402
Mailing address
PO BOX 366, 205 E MAPLE, BILLINGS, OK 74630
(580) 725-3400
(580) 725-3402
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH5204-5204
OK
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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