Organization
EASTERN OKLAHOMA COUNTY TECHNOLOGY
Active
Other names
EOC Sr Adult Services
Organization subpart
No
Provider details
NPI number
Authorized official
DARYL A CRUSOE (BUSINESS MANAGER)
(405) 390-6603
Entity
Organization
Contact information
Practice address
4601 N CHOCTAW RD, CHOCTAW, OK 73020-9017
(405) 390-4400
(405) 390-6637
Mailing address
4601 N CHOCTAW RD, CHOCTAW, OK 73020-9017
(405) 390-9591
(405) 390-6639
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
DC5505-5505
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100682160B
—
OK
Enumeration date
04/04/2007
Last updated
06/25/2008
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