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Organization
PAULS VALLEY CARE CENTER LLC
Active
Organization
PAULS VALLEY CARE CENTER LLC
Active
Other names
Pauls Valley Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BART REED (MANAGER)
(580) 436-0950
Entity
Organization
Contact information
Practice address
1413 S CHICKASAW ST, PAULS VALLEY, OK 73075-6415
(405) 238-6411
Mailing address
1413 S CHICKASAW ST, PAULS VALLEY, OK 73075-6415
(405) 238-6411
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH2504-2504
OK
314000000X
Skilled Nursing Facility
Primary
NH2504-2504
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778860A
—
OK
Enumeration date
08/20/2009
Last updated
04/07/2020
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