# IHS WYNNEWOOD CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wynnewood Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548455975
- **Authorized official:** MR. BART TAYLOR REED (PRESIDENT)
- **Authorized official phone:** (580) 436-0950

## Contact information

- **Practice address:** 131 N BROADWAY AVE, ADA, OK 74820-5003
- **Practice address phone:** (580) 436-0950
- **Practice address fax:** (580) 436-0953
- **Mailing address:** 810 E CALIFORNIA ST, WYNNEWOOD, OK 73098-3207
- **Mailing address phone:** (405) 665-2330
- **Mailing address fax:** (405) 943-4917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH2506-2506 | OK | Yes |
| 314000000X | Skilled Nursing Facility | NH2506-2506 | OK | — |

## Other

- **Enumeration date:** 09/10/2007
- **Last updated:** 09/24/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007767770A | — | OK |