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Organization
SOUTHWEST LTC - TEMPLE LLC
Active
Organization
SOUTHWEST LTC - TEMPLE LLC
Active
Other names
Temple Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD PAYNE (MANAGER)
(469) 916-6100
Entity
Organization
Contact information
Practice address
100 WEST GREEN AVE, TEMPLE, OK 73568
(580) 342-6228
Mailing address
5560 TENNYSON PKWY STE 210, PLANO, TX 75024-3582
(469) 916-6100
(469) 916-6105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200645870A
—
OK
05
—
NH1702
—
OK
Enumeration date
02/17/2015
Last updated
08/03/2022
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