NPIMap

Organization Active NPI

Sheltered Work Activity Program

  • Day Training/Habilitation Specialist
  • Muskogee, OK
National Provider Identifier
1336332303
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
Legal business name
SHELTERED WORK ACTIVITY PROGRAM
Practice address
210 E Okmulgee St
Muskogee, OK 74403-5453
Phone
(918) 683-8162
Fax
(918) 687-5368
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Dr. Edward B Breen, PHD
Title
Ceo
Phone
(918) 683-8162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 373H00000X Primary

Addresses

Primary practice location

210 E Okmulgee St
Muskogee, OK 74403-5453

Mailing address

210 E Okmulgee St
Muskogee, OK 74403-5453
Phone (918) 683-8162

Other identifiers 1

IdentifierTypeStateIssuer
100682680AMedicaidOK

Other names 1

  • SWAP Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Sheltered Work Activity Program Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1336332303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035453",
            "telephone_number": "918-683-8162",
            "fax_number": "918-687-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035453",
            "telephone_number": "918-683-8162",
            "fax_number": "918-687-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTERED WORK ACTIVITY PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "BREEN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-683-8162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100682680A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SWAP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.