# ILA SEATON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Willow Haven
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689807414
- **Authorized official:** ILA M SEATON (MEMBER)
- **Authorized official phone:** (918) 645-5905

## Contact information

- **Practice address:** 1301 N 5TH ST, TONKAWA, OK 74653-1513
- **Practice address phone:** (580) 628-2529
- **Practice address fax:** (580) 628-9066
- **Mailing address:** PO BOX 990, EDMOND, OK 73083-0990
- **Mailing address phone:** (405) 285-8166
- **Mailing address fax:** (405) 285-8177

## Taxonomy

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

## Other

- **Enumeration date:** 08/27/2009
- **Last updated:** 09/17/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200255140A | — | OK |