# COLES NURSING HOME LLC

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

## Provider details

- **NPI number:** 1811996770
- **Authorized official:** MS. TANDIE HASTINGS (MEMBER)
- **Authorized official phone:** (405) 282-6285

## Contact information

- **Practice address:** 2300 W NOBLE AVE, GUTHRIE, OK 73044-5504
- **Practice address phone:** (405) 282-1686
- **Practice address fax:** (405) 282-1681
- **Mailing address:** 2300 W NOBLE AVE, GUTHRIE, OK 73044-5504
- **Mailing address phone:** (405) 282-1686
- **Mailing address fax:** (405) 282-1681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH4201 | OK | — |
| 314000000X | Skilled Nursing Facility | NH4201 | OK | Yes |

## Other

- **Enumeration date:** 07/21/2005
- **Last updated:** 05/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100778230A | — | OK |