| Santa Fe Residential Care Home | |
|
618 E Canadian Ave Vinita OK 74301-3810 | |
| (918) 244-9876 | |
| Not Available |
| Full Name | Santa Fe Residential Care Home |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 618 E Canadian Ave, Vinita, Oklahoma |
| Authorized Official Name and Position | Vickie Jean Tipton (OWNER/OPERATOR) |
| Authorized Official Contact | 9182449876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Fe Residential Care Home Po Box 148 Vinita OK 74301-0148 Ph: (918) 244-9876 | Santa Fe Residential Care Home 618 E Canadian Ave Vinita OK 74301-3810 Ph: (918) 244-9876 |
| NPI Number | 1114351541 |
|---|---|
| Provider Enumeration Date | 08/21/2013 |
| Last Update Date | 08/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114351541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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