Provider Demographics
NPI:1063209336
Name:MOMENTS HOSPICE OF OKLAHOMA CITY LLC
Entity type:Organization
Organization Name:MOMENTS HOSPICE OF OKLAHOMA CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIYAHU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-666-3687
Mailing Address - Street 1:820 LILAC DR N STE 210
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4754
Mailing Address - Country:US
Mailing Address - Phone:877-666-3687
Mailing Address - Fax:763-205-9350
Practice Address - Street 1:3817 NW 58TH ST STE 104
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-1606
Practice Address - Country:US
Practice Address - Phone:877-666-3687
Practice Address - Fax:763-205-9350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based