NPI 1982938072

Legend at Jefferson's Garden

Organisation Physical Disabilities Residential Treatment Facility Edmond, OK

Practice location

Address: 15401 N Pennsylvania Ave, Edmond, OK 73013
Phone: (405) 715-1717
Fax: (405) 715-9017

Authorised official

Name: Nelda Randall
Title: Director
Phone: (405) 715-1717

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence AL5517-5517 (OK)

Other Residential Treatment Facility, Physical Disabilities providers in Oklahoma →

Registry record

NPI: 1982938072
Entity type: Organization
NPI issued: 23 Sep 2009
Record last updated: 23 Sep 2009

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.