Organization
LIGHTNING CREEK INVESTMENT GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG MADDUX (PRESIDENT)
(580) 994-5570
Entity
Organization
Contact information
Practice address
1100 MEMORIAL DR, CHEROKEE, OK 73728-3832
(580) 596-2141
Mailing address
PO BOX 468, NOWATA, OK 74048
(918) 273-3649
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0201-0201
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772060A
—
OK
05
—
10077206D
—
OK
Enumeration date
07/13/2006
Last updated
01/03/2018
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