# TOWN OF VICI

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

## Provider details

- **NPI number:** 1689664716
- **Authorized official:** MR. MICHAEL AARON BOONE B.S. BUSINESS ADMIN. (ADMINISTRATOR)
- **Authorized official phone:** (580) 995-4216

## Contact information

- **Practice address:** 619 SPECK, VICI, OK 73859-0119
- **Practice address phone:** (580) 995-4216
- **Practice address fax:** (580) 995-4237
- **Mailing address:** 619 SPECK, PO BOX 119, VICI, OK 73859-0119
- **Mailing address phone:** (580) 995-4216
- **Mailing address fax:** (580) 995-4237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2202-2202 | OK | Yes |

## Other

- **Enumeration date:** 10/28/2005
- **Last updated:** 06/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10077838A | — | OK |