JACKIE FIELDS FOUNDATION (NPI# 1578865317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578865317 |
| Entity Type | Organization |
| Organization Name | JACKIE FIELDS FOUNDATION |
| Practice Address |
2303 Pickens Muskogee OK 74402 |
| Mailing Address |
Pob 1810 2303 Pickens Muskigee OK 74402 |
| Practice Telephone | 9189136017 |
| Mailing Telephone | 9189136017 |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2010-11-30 |
| Authorized Official Name | JACKIE DEVORAH STANFORD (CEO) |
| Authorized Official Telephone | 9189136017 |
| Authorized Official Credential | ADM RESIDENTAL C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
2303 PICKENS |
| City | MUSKOGEE |
| State | OK |
| Zip Code | 74402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386250769 | Jessica Nicole Jacobs | Speech-Language Pathologist | 315 E Peak Blvd, Muskogee, OK 74403-8515 | 2020-09-21 |
| 1477166445 | Legacy Home Health, LLC | Home Health | 1631 N Main St Ste B, Muskogee, OK 74401-4451 | 2020-08-28 |
| 1609486406 | Glendon Jones | Pharmacist | 304 N York St, Muskogee, OK 74403-4658 | 2020-08-06 |
| 1437767308 | Christopher Bryan Essex | Nurse Practitioner | 4101 High Oaks St, Muskogee, OK 74401-1306 | 2020-07-16 |
| 1821612672 | Sandra Spiegel | Technician | 114 S 74th St W, Muskogee, OK 74401-8655 | 2020-06-07 |
| 1356965370 | Robin R Pollock | Case Manager/Care Coordinator | 1139 N Main St, Muskogee, OK 74401-4441 | 2020-06-05 |
| 1508486978 | Economy Pharmacy | Pharmacy | 3414 W. Okmulgee, Muskogee, OK 74401 | 2020-04-25 |
| 1528687894 | Monica Ha | Student in an Organized Health Care Education/Training Program | 545 N 12th St, Muskogee, OK 74401-5914 | 2020-04-15 |
| 1912532086 | Jill Ann Tanyan | Case Manager/Care Coordinator | 512 Burbank St, Muskogee, OK 74403-8303 | 2020-03-09 |
| 1912531252 | Lori Jefferson | Counselor | 207 S 11th St, Muskogee, OK 74401-6818 | 2020-02-25 |
| Find all providers in MUSKOGEE | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184978512 | National Community Dev Corp of Ok | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3115 S Winston Ave, Tulsa, OK 74135-2028 | 2012-11-07 |
| 1891042719 | Oklahoma Production Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216 West Ave., Tahlequah, OK 74464 | 2012-08-09 |
| 1407012156 | Sawyer Investments, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9810 E 45th Pl, Tulsa, OK 74146-4708 | 2008-08-01 |
| 1295995488 | L.c.a.r.c.,inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 319 W Oklahoma Ave, Guthrie, OK 73044 | 2008-06-11 |
| 1558582858 | Aid for Individual Development Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2805 N Utah Ave, Oklahoma City, OK 73107-1217 | 2007-05-02 |
| 1467570051 | Evergreen Ok Daily Living Support | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7725 W Britton Rd, Oklahoma City, OK 73132-1507 | 2007-03-26 |
| 1548385834 | Arc Group Homes, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 616 E 4th St, Bartlesville, OK 74003-3907 | 2007-03-19 |
| 1225153521 | Employment Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6202 S Lewis Ave Ste D, Tulsa, OK 74136-1064 | 2007-03-19 |
| 1285796276 | Incipient Care Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 776 S. Sara Rd, Tuttle, OK 73089-8648 | 2006-12-15 |
| 1982773107 | Dungarvin Oklahoma LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9210 S Western Ave Ste A-22, Oklahoma City, OK 73139-4982 | 2006-11-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.