# POTEAU NURSING CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Oaks Healthcare Center, The Oaks Health Care Center Poteau
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154310399
- **Authorized official:** MARK LIETZKE (CEO)
- **Authorized official phone:** (918) 622-4799

## Contact information

- **Practice address:** 1501 CLAYTON AVE, POTEAU, OK 74953-4102
- **Practice address phone:** (918) 647-8236
- **Practice address fax:** (918) 649-3747
- **Mailing address:** 1805 E 15TH ST, TULSA, OK 74104-4610
- **Mailing address phone:** (918) 622-4799
- **Mailing address fax:** (918) 622-4798

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH40094009 | OK | Yes |

## Other

- **Enumeration date:** 10/20/2005
- **Last updated:** 08/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000375166001 | BC/BS PROVIDEDR ID | OK |
| 05 | — | 100847080A | — | OK |