# BRENTWOOD EXTENDED CARE & REHAB. LLC

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

## Provider details

- **NPI number:** 1720161813
- **Authorized official:** MRS. BOBBIE MONTGOMERY (OWNER)
- **Authorized official phone:** (918) 683-9407

## Contact information

- **Practice address:** 841 N 38TH ST, MUSKOGEE, OK 74401-2056
- **Practice address phone:** (918) 683-8070
- **Practice address fax:** (918) 683-8234
- **Mailing address:** 1929 BETTY JANE LN, MUSKOGEE, OK 74403-1581
- **Mailing address phone:** (918) 683-9407
- **Mailing address fax:** (918) 683-1979

## Taxonomy

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

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2020