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Organization
OKEMAH CARE CENTER, LLC
Active
Organization
OKEMAH CARE CENTER, LLC
Active
Other names
OKEMAH CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
PAM HUMPHREYS (OWNER)
(405) 379-0039
Entity
Organization
Contact information
Practice address
112 N WOODY GUTHRIE ST, OKEMAH, OK 74859-2642
(918) 623-1126
(918) 623-1765
Mailing address
112 N WOODY GUTHRIE ST, OKEMAH, OK 74859-2642
(918) 623-1126
(918) 623-1765
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH5404-5404
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778260A
—
OK
Enumeration date
07/28/2005
Last updated
01/06/2025
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