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Organization
FOUNTAINS CANTERBURY SL, LLC
Active
Organization
FOUNTAINS CANTERBURY SL, LLC
Active
Other names
The Fountains at Canterbury
Organization subpart
No
Provider details
NPI number
Authorized official
GRETA FRUHLING FRAZIER (DIRECTOR)
(520) 797-4000
Entity
Organization
Contact information
Practice address
1404 NW 122ND ST, OKLAHOMA CITY, OK 73114-8000
(405) 751-3600
(405) 751-6511
Mailing address
2020 W RUDASILL RD, ATTN: MEDICARE BILLING, TUCSON, AZ 85704-7800
(520) 797-4000
(520) 797-7757
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
CC5503-5503
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100777120A
—
OK
Enumeration date
05/03/2006
Last updated
06/29/2010
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