Organization
GREEN ACRES RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN FARRIS (ADMINISTRATOR)
(918) 456-0704
Entity
Organization
Contact information
Practice address
612 W DOWNING ST, TAHLEQUAH, OK 74464-2716
(918) 456-8677
(918) 456-8677
Mailing address
612 W DOWNING ST, TAHLEQUAH, OK 74464-2716
(918) 456-8677
(918) 456-8677
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
310400000X
OK
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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