# WILLOW CREEK HEALTH CARE LLC

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

## Provider details

- **NPI number:** 1497084693
- **Authorized official:** MRS. TANDIE HASTINGS (MANAGER)
- **Authorized official phone:** (405) 282-6285

## Contact information

- **Practice address:** 2300 W NOBLE AVE, GUTHRIE, OK 73044-5504
- **Practice address phone:** (405) 282-1686
- **Practice address fax:** (405) 282-5731
- **Mailing address:** PO BOX 1095, GUTHRIE, OK 73044-1095
- **Mailing address phone:** (405) 282-6285
- **Mailing address fax:** (405) 282-5731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH4201 | OK | Yes |

## Other

- **Enumeration date:** 12/17/2009
- **Last updated:** 04/19/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100778230A | — | OK |