Organization
NEW FRONTIERS ICFMR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD MOORE (EXECUTIVE DIRECTOR)
(405) 789-2262
Entity
Organization
Contact information
Practice address
6809 CHISHOLM CT, OKLAHOMA CITY, OK 73127-4248
(405) 789-2262
Mailing address
1400 N COUNCIL RD, OKLAHOMA CITY, OK 73127-4918
(405) 789-2262
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH5569
OK
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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