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Organization
OPCO COWETA, OK, LLC
Active
Organization
OPCO COWETA, OK, LLC
Active
Other names
Coweta Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC DOLE (MANAGER)
(773) 645-9246
Entity
Organization
Contact information
Practice address
30049 E 151ST ST S, COWETA, OK 74429-4544
(918) 486-2166
Mailing address
2045 W GRAND AVE STE B34572, CHICAGO, IL 60612-1576
(312) 724-8950
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/15/2021
Last updated
10/29/2024
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