# LIGHTNING CREEK INVESTMENT GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MOORELAND HERITAGE MANOR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346385689
- **Authorized official:** MR. DOUGLAS G. MADDUX (PRESIDENT)
- **Authorized official phone:** (918) 273-3649

## Contact information

- **Practice address:** 402 SE 6TH ST, MOORELAND, OK 73852-9064
- **Practice address phone:** (918) 273-3649
- **Practice address fax:** (918) 273-5652
- **Mailing address:** PO BOX 468, NOWATA, OK 74048-0468
- **Mailing address phone:** (918) 273-3649
- **Mailing address fax:** (918) 273-5652

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH7702-7702 | OK | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 07/20/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100776120B | — | OK |