# HASKELL CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** haskell care center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891795100
- **Authorized official:** PAM HUMPHREYS (OWNER)
- **Authorized official phone:** (405) 379-0039

## Contact information

- **Practice address:** 405 N CHOCTAW AVENUE, HASKELL, OK 74436-1319
- **Practice address phone:** (918) 482-3310
- **Practice address fax:** (918) 482-6801
- **Mailing address:** 405 N CHOCTAW AVENUE, HASKELL, OK 74436-1319
- **Mailing address phone:** (918) 482-3310
- **Mailing address fax:** (918) 482-6901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH5104-5104 | OK | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 01/06/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100772190A | — | OK |