NPI 1104174267

Fidelis One LLC

Organisation Assisted Living Facility Oklahoma City, OK

Practice location

Address: 4825 NW 23rd St, Oklahoma City, OK 73127
Phone: (405) 945-0010
Fax: (405) 947-6542
Mailing address: 4601 N Classen Blvd, Oklahoma City, OK 73118

Authorised official

Name: Shantharam Darbe
Title: Owner/Manager
Phone: (405) 840-9991

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence AL5516 (OK)

Other Assisted Living Facility providers in Oklahoma →

Registry record

NPI: 1104174267
Entity type: Organization
NPI issued: 21 Aug 2012
Record last updated: 24 Aug 2012

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.