# AWENASA MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Care Center of Fairland
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528336252
- **Authorized official:** MS. TERESA MAHURIN (MANAGING MEMBER)
- **Authorized official phone:** (918) 476-6642

## Contact information

- **Practice address:** 12 E CONNER AVE., FAIRLAND, OK 74343-0336
- **Practice address phone:** (918) 676-3685
- **Practice address fax:** (918) 676-3008
- **Mailing address:** 5430 W 640, CHOUTEAU, OK 74337-5504
- **Mailing address phone:** (918) 476-6642
- **Mailing address fax:** (918) 476-4679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |
| 314000000X | Skilled Nursing Facility | — | NULL | — |

## Other

- **Enumeration date:** 12/08/2011
- **Last updated:** 12/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 37-5515 | MEDICARE CCN | — |
| 05 | — | 37E258 | — | OK |