# HERITAGE VILLAGE NURSING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Village Nursing Home, Heritage Village Nursing Center LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285724732
- **Authorized official:** DONNA SIMMONS (LNHA)
- **Authorized official phone:** (405) 380-6671

## Contact information

- **Practice address:** 801 HIGHWAY 48, HOLDENVILLE, OK 74848-9792
- **Practice address phone:** (405) 379-6671
- **Practice address fax:** (405) 379-6674
- **Mailing address:** 801 HIGHWAY 48, HOLDENVILLE, OK 74848-9792
- **Mailing address phone:** (405) 379-6671
- **Mailing address fax:** (405) 379-6674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH3205-3205 | OK | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 09/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200111530A | — | OK |