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Organization
PHOENIX HEALTH CARE, LLC
Active
Organization
PHOENIX HEALTH CARE, LLC
Active
Other names
Southern Oaks
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN A. FONDREN (ADMINISTRATOR)
(918) 762-2515
Entity
Organization
Contact information
Practice address
1401 4TH ST, PAWNEE, OK 74058-5003
(918) 762-2515
(918) 762-3704
Mailing address
1401 4TH ST, PAWNEE, OK 74058-5003
(918) 762-2515
(918) 762-3704
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH5902-5902
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200040930E
—
OK
Enumeration date
07/31/2006
Last updated
05/14/2026
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