# NOWATA LTC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NOWATA NURSING CENTER, El Reno Health Care, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003659855
- **Authorized official:** MR. GREGORY LANCE GUYMON (CONSULTANT)
- **Authorized official phone:** (405) 312-8050

## Contact information

- **Practice address:** 436 S JOE ST, NOWATA, OK 74048-3233
- **Practice address phone:** (918) 775-4439
- **Practice address fax:** (918) 775-9242
- **Mailing address:** 210 E CHOCTAW AVE, SALLISAW, OK 74955-4604
- **Mailing address phone:** (918) 775-4439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2024
- **Last updated:** 06/18/2024