Organization Name: | ST. JOHN HOME CARE LLC |
NPI Number: | 1265514145 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SR. M. THERESE GOTTSCHALK (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 4720 S Harvard Ave Ste 202 Tulsa |
State: | OK US |
Postal Code: | 741353071 |
Phone Number: | 9187477901 |
Fax Number: | |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 08/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 2265 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |