# SOUTHWEST LTC TUTTLE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tuttle Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861884348
- **Authorized official:** RONALD PAYNE (CEO)
- **Authorized official phone:** (469) 916-6100

## Contact information

- **Practice address:** 104 SE 4TH ST, TUTTLE, OK 73089-8825
- **Practice address phone:** (405) 381-3363
- **Mailing address:** 1518 LEGACY DR, SUITE 110, FRISCO, TX 75034-6038
- **Mailing address phone:** (469) 916-6100
- **Mailing address fax:** (469) 916-6105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/20/2015
- **Last updated:** 02/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200093870B | — | OK |