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Organization
ELK CITY NURSING HOME LLC
Active
Organization
ELK CITY NURSING HOME LLC
Active
Other names
elk city nursing center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX WADE DOUT (MANAGER)
(918) 333-9545
Entity
Organization
Contact information
Practice address
301 GARRETT, ELK CITY, OK 73648-3113
(580) 225-2811
Mailing address
301 GARRETT ST, ELK CITY, OK 73644-3113
(580) 225-2811
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0503-0503
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100771120A
—
OK
Enumeration date
07/13/2009
Last updated
10/28/2009
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