# AMBASSADOR MANOR NURSING CENTER L.L.C.

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

## Provider details

- **NPI number:** 1609874528
- **Authorized official:** MRS. BEVERLY LATIMER (CFO)
- **Authorized official phone:** (918) 743-8978

## Contact information

- **Practice address:** 1340 E 61ST ST, TULSA, OK 74136-0605
- **Practice address phone:** (918) 743-8978
- **Practice address fax:** (918) 749-5841
- **Mailing address:** 1340 E 61ST ST, TULSA, OK 74136-0605
- **Mailing address phone:** (918) 743-8978
- **Mailing address fax:** (918) 749-5841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH72017201 | OK | Yes |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 09/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100806180A | — | OK |
| 05 | — | 100806180B | — | OK |