Organization
PHOENIX HEALTHCARE LLC
Active
Parent organization
PHOENIX HEALTHCARE LLC
Other names
Rest Haven Nursing Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX HEALTHCARE LLC
Authorized official
ANGELA MATTHEWS (MEDICARE SPECIALIST)
(918) 743-3638
Entity
Organization
Contact information
Practice address
1944 N IROQUOIS AVE, TULSA, OK 74106-4407
(918) 583-1509
(918) 583-1804
Mailing address
1944 N IROQUOIS AVE, TULSA, OK 74106-4407
(918) 583-1509
(918) 583-1804
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH7221
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200040930H
—
OK
Enumeration date
07/29/2006
Last updated
08/08/2008
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