Organization
REST HAVEN MANAGEMENT INC. FOURSEE '4C'
Active
Other names
FourSee '4C', Rest Haven Management Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ENETRICE RENNE MYERS AS, BBA, MBA (EXECUTOR/BUSINESS OPERATION MANAGER)
(317) 919-2923
Entity
Organization
Contact information
Practice address
368015 OLD HIGHWAY 62, BOLEY, OK 74829-2914
(918) 667-3372
Mailing address
368015 OLD HIGHWAY 62, BOLEY, OK 74829-2914
(918) 667-3372
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
OK
Other
Enumeration date
07/30/2017
Last updated
07/21/2022
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