# CORDELL CHRISTIAN HOME INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326059676
- **Authorized official:** MS. ROBERTA GAIL WILCOX (ADMINISTRATOR)
- **Authorized official phone:** (580) 832-3371

## Contact information

- **Practice address:** 1400 N COLLEGE ST, CORDELL, OK 73632-1822
- **Practice address phone:** (580) 832-3371
- **Practice address fax:** (580) 832-2732
- **Mailing address:** 1400 N COLLEGE ST, CORDELL, OK 73632-1822
- **Mailing address phone:** (580) 832-3371
- **Mailing address fax:** (580) 832-2732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH7501-7501 | OK | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 01/21/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100773140 A | — | OK |