Organization
LAKE FRANCIS RESIDENTIAL CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSENA MCINTOSH (ADMINISTRATOR)
(918) 457-5535
Entity
Organization
Contact information
Practice address
27753 S WELLING RD, WELLING, OK 74471-2202
(918) 422-9907
Mailing address
27753 S WELLING RD, WELLING, OK 74471-2202
(918) 457-5535
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
RC 0101-0101
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC 0101-0101
STATE LICENSE
OK
Enumeration date
03/07/2007
Last updated
08/22/2020
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