Organization
FAIR OAKS RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE WILSON LPN (ADMINISTRATOR)
(918) 260-5422
Entity
Organization
Contact information
Practice address
1330 N 3RD ST, LANGLEY, OK 74350
(918) 782-3180
(918) 782-9715
Mailing address
PO BOX 475, LANGLEY, OK 74350-0475
(918) 782-3180
(918) 782-9175
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
RC4902-4902
OK
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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