# CEDAR CREST MANOR INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1689745291
- **Authorized official:** MRS. TARRI ALDRIDGE (BOARD MEMBER)
- **Authorized official phone:** (580) 355-1616

## Contact information

- **Practice address:** 1700 NW FORT SILL BLVD, LAWTON, OK 73507-4064
- **Practice address phone:** (580) 355-1616
- **Practice address fax:** (580) 355-2814
- **Mailing address:** 1700 NW FORT SILL BLVD, LAWTON, OK 73507-4064
- **Mailing address phone:** (580) 355-1616
- **Mailing address fax:** (580) 355-2814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH1602-1602 | OK | Yes |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 07/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100773120A | — | OK |
| 01 | — | 37E548 | FEDERAL ID NUMBER | OK |