Organization
JENESIS CARE HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY JACKSON (PRESIDENT)
(918) 629-9354
Entity
Organization
Contact information
Practice address
8234 S SANDUSKY AVE, TULSA, OK 74137-1833
(918) 629-9354
(832) 487-8009
Mailing address
528 E READING ST, TULSA, OK 74106-4326
(918) 629-9354
(832) 487-8009
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
RC7272-7272
OK
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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