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Organization
ELMWOOD MANOR NURSING HOME LLC
Active
Organization
ELMWOOD MANOR NURSING HOME LLC
Active
Other names
ELMWOOD MANOR NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
PAM HUMPHREYS (OWNER)
(405) 379-0039
Entity
Organization
Contact information
Practice address
300 S SEMINOLE AVE, WEWOKA, OK 74884-2557
(405) 257-6621
(405) 257-6402
Mailing address
PO BOX 975, WEWOKA, OK 74884-0975
(405) 257-6621
(405) 257-6402
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH6701-6701
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200047510A
—
OK
Enumeration date
07/28/2005
Last updated
01/06/2025
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