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Organization
OK4 FT. GIBSON OPCO LLC
Active
Organization
OK4 FT. GIBSON OPCO LLC
Active
Other names
Fort Gibson Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC DOLE (MANAGER/PRINCIPAL)
(773) 645-9246
Entity
Organization
Contact information
Practice address
205 E POPLAR ST, FORT GIBSON, OK 74434-8272
(918) 478-2456
Mailing address
2045 W GRAND AVE STE B-34572, CHICAGO, IL 60612-1576
(773) 645-9246
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
OK
Other
Enumeration date
05/03/2016
Last updated
10/29/2024
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