# ELK CITY NURSING HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** elk city nursing center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851520894
- **Authorized official:** MR. ALEX WADE DOUT (MANAGER)
- **Authorized official phone:** (918) 333-9545

## Contact information

- **Practice address:** 301 GARRETT, ELK CITY, OK 73648-3113
- **Practice address phone:** (580) 225-2811
- **Mailing address:** 301 GARRETT ST, ELK CITY, OK 73644-3113
- **Mailing address phone:** (580) 225-2811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0503-0503 | OK | Yes |

## Other

- **Enumeration date:** 07/13/2009
- **Last updated:** 10/28/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100771120A | — | OK |