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Organization
SOUTHWEST LTC TUTTLE LLC
Active
Organization
SOUTHWEST LTC TUTTLE LLC
Active
Other names
Tuttle Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD PAYNE (CEO)
(469) 916-6100
Entity
Organization
Contact information
Practice address
104 SE 4TH ST, TUTTLE, OK 73089-8825
(405) 381-3363
Mailing address
1518 LEGACY DR, SUITE 110, FRISCO, TX 75034-6038
(469) 916-6100
(469) 916-6105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200093870B
—
OK
Enumeration date
02/20/2015
Last updated
02/20/2015
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