Individual
THANH HOANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2448 W NEW ORLEANS ST, BROKEN ARROW, OK 74011-1590
(918) 286-4980
(918) 286-4970
Mailing address
2801 W GARY ST, BROKEN ARROW, OK 74012-7599
(918) 688-4846
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC8114
OK
372600000X
Adult Companion
HC8114
OK
374U00000X
Home Health Aide
HC8114
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC8114
STATE OF OKLAHOMA DEPT OF HEALTH LICENSE NUMBER
OK
Enumeration date
02/04/2020
Last updated
02/04/2020
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