Organization Name: | DUNCAN COMMUNITY RESIDENCE, INC |
NPI Number: | 1215150537 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN D WOLFF (ADMINISTRATOR) |
Mailing Address: | 1510 W Main St Duncan |
State: | OK US |
Postal Code: | 735334333 |
Phone Number: | 5802553926 |
Fax Number: | 5802558877 |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 11/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | RC6901-6901 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |