# SOUTHBROOK HEALTHCARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013916311
- **Authorized official:** MR. TOM C COBLE (OWNER)
- **Authorized official phone:** (580) 226-3055

## Contact information

- **Practice address:** 832 ISABEL ST, ARDMORE, OK 73401-5118
- **Practice address phone:** (580) 223-5901
- **Practice address fax:** (580) 226-0841
- **Mailing address:** 832 ISABEL ST, ARDMORE, OK 73401-5118
- **Mailing address phone:** (580) 223-5901
- **Mailing address fax:** (580) 226-0841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH1006-1006 | OK | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 03/07/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100777570A | — | OK |