NPIMap

Organization Active NPI

Duncan Community Residence, Inc

  • Assisted Living Facility (Mental Illness)
  • Duncan, OK
National Provider Identifier
1215150537
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
RC6901-6901 Issued in OK
Legal business name
DUNCAN COMMUNITY RESIDENCE, INC
Practice address
1510 W Main St
Duncan, OK 73533-4333
Phone
(580) 255-3926
Fax
(580) 255-8877
NPI assigned
Apr 11, 2007
Last updated
Nov 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brian D Wolff
Title
Administrator
Phone
(580) 255-3926

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X RC6901-6901 OK Primary
Mental Illness Community Based Residential Treatment Facility 320800000X RC6901-6901 OK

Addresses

Primary practice location

1510 W Main St
Duncan, OK 73533-4333

Mailing address

PO Box 1474
1510 W. Main
Duncan, OK 73534-1474
Phone (580) 255-3926

National Provider Directory

National Provider Directory

Locations

1530 W Main St
Duncan, OK 73533
Phone (580) 255-3926

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1215150537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1474",
            "address_2": "1510 W. MAIN",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735341474",
            "telephone_number": "580-255-3926",
            "fax_number": "580-255-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W MAIN ST",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735334333",
            "telephone_number": "580-255-3926",
            "fax_number": "580-255-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNCAN COMMUNITY RESIDENCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-255-3926",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "OK",
            "license": "RC6901-6901",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OK",
            "license": "RC6901-6901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.