# PSG - WILLOW PARK LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1821093352
- **Authorized official:** MRS. CHERYL HANKINS (ADMINISTRATOR)
- **Authorized official phone:** (580) 536-1279

## Contact information

- **Practice address:** 7019 NW CACHE RD, LAWTON, OK 73505-2707
- **Practice address phone:** (580) 536-1279
- **Practice address fax:** (580) 510-0017
- **Mailing address:** 7019 NW CACHE RD, LAWTON, OK 73505-2707
- **Mailing address phone:** (580) 536-1279
- **Mailing address fax:** (580) 510-0017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH1607-1607 | OK | Yes |
| 314000000X | Skilled Nursing Facility | NH 16071607 | OK | — |

## Other

- **Enumeration date:** 06/21/2005
- **Last updated:** 09/11/2025