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Organization

HOSPICE OF OWASSO, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA K KELSO (OWNER)
(918) 274-0333
Entity
Organization

Contact information

Practice address
202 S CEDAR ST, SUITE A, OWASSO, OK 74055-3451
(918) 274-0333
(918) 274-0435
Mailing address
202 S CEDAR ST, SUITE A, OWASSO, OK 74055-3451
(918) 274-0333
(918) 274-0435

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
4178
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4178
HOSPICE LICENSE NUMBER
OK
Enumeration date
11/04/2005
Last updated
08/22/2020
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