NPIMap

Organization Active NPI

Rest Haven Management Inc. Foursee '4C'

Doing business as FourSee '4C'

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Boley, OK
National Provider Identifier
1770007908
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
REST HAVEN MANAGEMENT INC. FOURSEE '4C'
Doing business as
FourSee '4C'
Rest Haven Management Inc.
Practice address
368015 Old Highway 62
Boley, OK 74829-2914
Phone
(918) 667-3372
NPI assigned
Jul 30, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Enetrice Renne Myers, AS, BBA, MBA
Title
Executor/Business Operation Manager
Phone
(317) 919-2923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X OK Primary

Addresses

Primary practice location

368015 Old Highway 62
Boley, OK 74829-2914

Mailing address

368015 Old Highway 62
Boley, OK 74829-2914
Phone (918) 667-3372

Other names 2

  • FourSee '4C' Doing business as
  • Rest Haven Management Inc. Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1501372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770007908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368015 OLD HIGHWAY 62",
            "city": "BOLEY",
            "state": "OK",
            "postal_code": "748292914",
            "telephone_number": "918-667-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368015 OLD HIGHWAY 62",
            "city": "BOLEY",
            "state": "OK",
            "postal_code": "748292914",
            "telephone_number": "918-667-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REST HAVEN MANAGEMENT INC. FOURSEE '4C'",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "ENETRICE",
        "authorized_official_middle_name": "RENNE",
        "authorized_official_title_or_position": "EXECUTOR/BUSINESS OPERATION MANAGER",
        "authorized_official_telephone_number": "317-919-2923",
        "authorized_official_credential": "AS, BBA, MBA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FourSee '4C'",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FourSee '4C'",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rest Haven Management Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boley, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.