# STILWELL NURSING HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922219716
- **Authorized official:** TANDIE HASTINGS (MANAGING MEMBER)
- **Authorized official phone:** (405) 282-6285

## Contact information

- **Practice address:** 509 W LOCUST ST, STILWELL, OK 74960-3644
- **Practice address phone:** (918) 696-7715
- **Practice address fax:** (918) 696-4638
- **Mailing address:** PO BOX 1095, GUTHRIE, OK 73044-1095
- **Mailing address phone:** (405) 282-6285
- **Mailing address fax:** (405) 282-5731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0101 | OK | Yes |

## Other

- **Enumeration date:** 05/24/2007
- **Last updated:** 11/29/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200114540A | — | OK |