Provider Demographics
NPI:1861543159
Name:HENLEY CARE LLC
Entity type:Organization
Organization Name:HENLEY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-478-5187
Mailing Address - Street 1:PO BOX 14655
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73113-0655
Mailing Address - Country:US
Mailing Address - Phone:405-478-5187
Mailing Address - Fax:
Practice Address - Street 1:8800 HENLEY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-4006
Practice Address - Country:US
Practice Address - Phone:405-478-5187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNONE251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services