# PHOENIX HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHOENIX HEALTHCARE LLC
- **Other names:** Rest Haven Nursing Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104830421
- **Legal business name:** PHOENIX HEALTHCARE LLC
- **Authorized official:** ANGELA MATTHEWS (MEDICARE SPECIALIST)
- **Authorized official phone:** (918) 743-3638

## Contact information

- **Practice address:** 1944 N IROQUOIS AVE, TULSA, OK 74106-4407
- **Practice address phone:** (918) 583-1509
- **Practice address fax:** (918) 583-1804
- **Mailing address:** 1944 N IROQUOIS AVE, TULSA, OK 74106-4407
- **Mailing address phone:** (918) 583-1509
- **Mailing address fax:** (918) 583-1804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH7221 | OK | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 08/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200040930H | — | OK |