# GIPSON AND BASE AT WILLOW HAVEN LLC

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

## Provider details

- **NPI number:** 1679698443
- **Authorized official:** ELIZABETH BASE (RECEIVER)
- **Authorized official phone:** (405) 447-3000

## Contact information

- **Practice address:** 1301 N 5TH ST, TONKAWA, OK 74653-1513
- **Practice address phone:** (580) 628-2529
- **Mailing address:** 114 S PETERS AVE, NORMAN, OK 73069-6034
- **Mailing address phone:** (405) 447-3000

## Taxonomy

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

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 08/22/2020