Organization
OAKRIDGE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN MCGREW (BUSINESS MANAGEMENT)
(918) 775-4439
Entity
Organization
Contact information
Practice address
210 E CHOCTAW AVE, SALLISAW, OK 74955-4604
(918) 775-4439
(918) 775-9242
Mailing address
PO BOX 429, SALLISAW, OK 74955-0429
(918) 775-4439
(918) 775-9242
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
OK
Other
Enumeration date
05/18/2006
Last updated
08/22/2020
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