Organization
WVL I LP
Active
Other names
FAYE'S PLACE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFF MACHTOLFF (ADMINISTRATOR)
(405) 282-5775
Entity
Organization
Contact information
Practice address
2102 WEST WARNER, GUTHRIE, OK 73044
(405) 282-5775
(405) 282-5795
Mailing address
PO BOX 977, GUTHRIE, OK 73044
(405) 282-2600
(405) 282-2610
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH4209
OK
Other
Enumeration date
08/18/2009
Last updated
09/08/2011
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