# TIDWELL FAMILY HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Quinton Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255702791
- **Authorized official:** DARREN TIDWELL (MANAGER)
- **Authorized official phone:** (918) 465-9300

## Contact information

- **Practice address:** 1209 W MAIN ST, QUINTON, OK 74561
- **Practice address phone:** (918) 469-2600
- **Practice address fax:** (918) 469-2208
- **Mailing address:** 225 W MAIN ST, WILBURTON, OK 74578-4045
- **Mailing address phone:** (918) 465-9300
- **Mailing address fax:** (918) 465-9303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH 6106-6106 | OK | Yes |

## Other

- **Enumeration date:** 10/09/2015
- **Last updated:** 07/07/2023