Organization
SOUL SURVIVOR SUPPORTIVE LIVING FDN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLA SPEED (FOUNDER)
(405) 863-5578
Entity
Organization
Contact information
Practice address
3612 OAK GROVE DR, MIDWEST CITY, OK 73110-3728
(405) 863-5578
Mailing address
PO BOX 932, BETHANY, OK 73008-0932
(405) 863-5578
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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