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Organization
SILVERCREST MANOR NURSING HOME INC
Active
Organization
SILVERCREST MANOR NURSING HOME INC
Active
Other names
Legacy Living Centers
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE PITA (INSURANCE/MEDICARE)
(580) 622-6300
Entity
Organization
Contact information
Practice address
301 W WASHINGTON AVE, ANADARKO, OK 73005-2442
(405) 247-3346
(405) 247-5635
Mailing address
301 W WASHINGTON AVE, ANADARKO, OK 73005-2442
(405) 247-3346
(405) 247-5635
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH0805-0805
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375477001
BLUE CROSS BLUE SHIELD OK
OK
05
—
200059970A
—
OK
Enumeration date
10/12/2005
Last updated
05/22/2008
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