# OKEMAH CARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OKEMAH CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437159761
- **Authorized official:** PAM HUMPHREYS (OWNER)
- **Authorized official phone:** (405) 379-0039

## Contact information

- **Practice address:** 112 N WOODY GUTHRIE ST, OKEMAH, OK 74859-2642
- **Practice address phone:** (918) 623-1126
- **Practice address fax:** (918) 623-1765
- **Mailing address:** 112 N WOODY GUTHRIE ST, OKEMAH, OK 74859-2642
- **Mailing address phone:** (918) 623-1126
- **Mailing address fax:** (918) 623-1765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH5404-5404 | OK | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 01/06/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100778260A | — | OK |