NPI 1073994596

Abrighterlightresdiential Care Home LLC

Organisation Physical Disabilities Residential Treatment Facility Broken Arrow, OK

Practice location

Address: 2708 S Hemlock Ave, Broken Arrow, OK 74012-0817
Phone: (918) 378-5686
Fax: (918) 286-1404

Authorised official

Name: Patti Lynn Birge
Title: Owner/Administor
Phone: (918) 378-5686

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence RC7276 (OK)

Other Residential Treatment Facility, Physical Disabilities providers in Oklahoma →

Registry record

NPI: 1073994596
Entity type: Organization
NPI issued: 10 Jun 2015
Record last updated: 10 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.