# SPANISH COVE HOUSING AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spanish Cove Retirement Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982947172
- **Authorized official:** DONALD N. BLOSE (CEO & EXECUTIVE ADMINISTRATOR)
- **Authorized official phone:** (405) 354-1901

## Contact information

- **Practice address:** 11 PALM AVE, YUKON, OK 73099-5645
- **Practice address phone:** (405) 354-1901
- **Practice address fax:** (405) 354-6584
- **Mailing address:** 11 PALM AVE, YUKON, OK 73099-5645
- **Mailing address phone:** (405) 354-1901
- **Mailing address fax:** (405) 354-6584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | — |
| 251G00000X | Community Based Hospice Care Agency | — | — | — |
| 314000000X | Skilled Nursing Facility | CC0901-0901 | OK | Yes |

## Other

- **Enumeration date:** 04/05/2013
- **Last updated:** 10/14/2024