Organization
PSG TEMPLE LLC
Active
Other names
Temple Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCRETIA LEE PARKEY (EXECUTIVE DIRECTOR)
(580) 342-6228
Entity
Organization
Contact information
Practice address
100 GREEN AVE, TEMPLE, OK 73568
(580) 342-6228
(580) 342-5015
Mailing address
100 GREEN AVENUE, TEMPLE, OK 73568
(580) 342-6228
(580) 342-5015
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1702
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200055110C
—
OK
05
—
200102030A
—
OK
Enumeration date
06/23/2005
Last updated
05/30/2013
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