Organization
STATE OF OKLAHOMA HUMAN SERVICES
Active
Other names
Robert M. Greer Center/Suite C-Building 3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID EWING LNHA (LICENSED NURSING HOME ADMINISTRATOR)
(580) 805-1400
Entity
Organization
Contact information
Practice address
2616 NORTH 30TH STREET, ENID, OK 73701-8760
(580) 213-2700
(580) 358-8013
Mailing address
2616 NORTH 30TH STREET, ENID, OK 73701-8760
(580) 213-2700
(580) 358-8013
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100769310-A
—
OK
Enumeration date
05/21/2025
Last updated
05/21/2025
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