OrganizationActive
3c Old Fashion Boarding Home
NPI 1124359047 · Assisted Living Facility (Mental Illness) · Prague, OK
Provider details
- NPI number
- 1124359047
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Authorized official
- Jvon Cook, Owner
Practice location
719 S Jim Thorpe Blvd
Nbu 1706
Prague, OK 74864-3505
Phone: (405) 567-2280
Fax: (405) 567-2280
Mailing address
719 S Jim Thorpe Blvd
Prague, OK 74864-3505
Registry dates
- Enumerated
- 2010-01-15
- Last updated
- 2010-01-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.