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Organization
CORN HERITAGE VILLAGE OF WEATHERFORD INC
Active
Organization
CORN HERITAGE VILLAGE OF WEATHERFORD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN HALL (EXECUTIVE DIRECTOR)
(580) 343-2295
Entity
Organization
Contact information
Practice address
801 N WASHINGTON ST, WEATHERFORD, OK 73096-4032
(580) 772-3993
(580) 774-1032
Mailing address
801 N WASHINGTON ST, WEATHERFORD, OK 73096-4032
(580) 772-3993
(580) 774-1032
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH2002
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200076200A
—
OK
Enumeration date
04/07/2006
Last updated
06/01/2009
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