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Organization
HEAVENER MANOR, LLC
Active
Organization
HEAVENER MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD MONTGOMERY (MEMBER)
(479) 250-5558
Entity
Organization
Contact information
Practice address
204 W 1ST ST, HEAVENER, OK 74937-2062
(918) 653-2034
(918) 653-4518
Mailing address
9 PROFESSIONAL DR, BELLA VISTA, AR 72715-8462
(479) 259-5558
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH4001-4001
OK
Other
Enumeration date
04/03/2014
Last updated
06/07/2024
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