Organization
GUTHRIE COTTAGES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL BUSH (CFO)
(405) 285-8166
Entity
Organization
Contact information
Practice address
405 N 20TH ST, GUTHRIE, OK 73044-2103
(405) 285-8166
Mailing address
3325 FRENCH PARK DR, SUITE 6, EDMOND, OK 73034-7277
(405) 285-8166
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH4208
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100771000A
—
OK
Enumeration date
09/24/2015
Last updated
09/24/2015
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