| NPI | 1124359047 |
|---|---|
| Doing Business As | 3C OLD FASHION BOARDING HOME |
| Entity Type | Organization |
| Authorized Contact | JVON COOK Owner 405-567-7677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |