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Organization
WILDWOOD MANAGEMENT COMPANY, L.L.C.
Active
Organization
WILDWOOD MANAGEMENT COMPANY, L.L.C.
Active
Other names
Wildwood Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED RUCKER (MEMBER)
(918) 743-7838
Entity
Organization
Contact information
Practice address
3333 E 28TH ST, TULSA, OK 74114-5915
(918) 747-8008
(918) 748-5970
Mailing address
1815 E SKELLY DR, TULSA, OK 74105-5919
(918) 743-7838
(918) 748-5970
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH7209-7209
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200119170A
—
OK
Enumeration date
02/14/2007
Last updated
05/31/2011
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