Organization
HOMESTEAD RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA KELLEY (MEMBER)
(918) 782-9969
Entity
Organization
Contact information
Practice address
35284 S 4440 RD, VINITA, OK 74301-7079
(918) 527-7462
Mailing address
PO BOX 554, VINITA, OK 74301-0554
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC1811-1811
OK
Other
Enumeration date
05/09/2007
Last updated
11/20/2009
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