Provider Demographics
NPI:1104071257
Name:THERAPEUTIC CARE DIMENSIONS INC
Entity type:Organization
Organization Name:THERAPEUTIC CARE DIMENSIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:405-650-7577
Mailing Address - Street 1:419 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-7117
Mailing Address - Country:US
Mailing Address - Phone:405-809-4200
Mailing Address - Fax:405-364-5379
Practice Address - Street 1:12101 N MACARTHUR BLVD
Practice Address - Street 2:STE 103
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1800
Practice Address - Country:US
Practice Address - Phone:405-650-7577
Practice Address - Fax:405-470-7428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0029205363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty