# HARMON COUNTY HEALTHCARE TRUST AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HARMON COUNTY HEALTHCARE TRUST AUTHORITY
- **Other names:** Colonial Manor II
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639166085
- **Legal business name:** HARMON COUNTY HEALTHCARE TRUST AUTHORITY
- **Authorized official:** MS. HOPE SMITH (ADMINISTRATOR)
- **Authorized official phone:** (580) 688-9431

## Contact information

- **Practice address:** 120 W VERSA ST, HOLLIS, OK 73550-3046
- **Practice address phone:** (580) 688-9431
- **Practice address fax:** (580) 688-2491
- **Mailing address:** PO BOX 793, HOLLIS, OK 73550-0793
- **Mailing address phone:** (580) 688-9431
- **Mailing address fax:** (580) 688-2491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH2902-2902 | OK | Yes |

## Other

- **Enumeration date:** 09/30/2005
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100772150A | — | OK |