Provider Demographics
NPI:1285455568
Name:GUIDE CARING HOME LLC
Entity type:Organization
Organization Name:GUIDE CARING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:TOUAYEM
Authorized Official - Last Name:MBOU
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:405-413-1826
Mailing Address - Street 1:12720 HERITAGE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-2078
Mailing Address - Country:US
Mailing Address - Phone:405-413-1826
Mailing Address - Fax:
Practice Address - Street 1:12412 PITTSBURGH AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6000
Practice Address - Country:US
Practice Address - Phone:405-413-1826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities