| NPI | 1821159922 |
|---|---|
| Former Legal Business Name | PROVIDENCE OF OKLAHOMA |
| Entity Type | Organization |
| Authorized Contact | NANCY POE Contract Administrator 520-570-1460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-10-17 |