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Organization
ELMBROOK HOME, INC.
Active
Organization
ELMBROOK HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM COBLE (OWNER)
(580) 226-3055
Entity
Organization
Contact information
Practice address
1811 9TH AVE NW, ARDMORE, OK 73401-2326
(580) 223-3303
(580) 223-1763
Mailing address
1811 9TH AVE NW, ARDMORE, OK 73401-2326
(580) 223-3303
(580) 223-1763
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH10031003
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100776890A
—
OK
Enumeration date
07/19/2005
Last updated
03/03/2016
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