Organization
CARE FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH DISMUKE (MANAGER)
(405) 524-5525
Entity
Organization
Contact information
Practice address
3621 N KELLEY AVE, SUITE 100, OKLAHOMA CITY, OK 73111-4520
(405) 621-5952
(405) 621-5952
Mailing address
3621 N KELLEY AVE, SUITE 100, OKLAHOMA CITY, OK 73111-4520
(405) 621-5952
(405) 621-5952
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
101YA0400X
OK
Other
Enumeration date
01/14/2011
Last updated
01/18/2011
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