Organization
PIONEER LIVING CENTER OPS LLC
Active
Other names
Heartway at Pioneer Living Center - Aspen Place
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY SUZETTE BAUCOM (REGIONAL DIRECTOR)
(479) 312-8280
Entity
Organization
Contact information
Practice address
202 E 1ST ST, WETUMKA, OK 74883-6041
(405) 452-3205
Mailing address
1305 SE ADAMS ST, IDABEL, OK 74745-5240
(580) 286-1065
(580) 286-3926
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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