Organization
SUMMIT HEALTHCARE RECEIVERSHIP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY GOODMAN (RECEIVER)
(405) 769-7990
Entity
Organization
Contact information
Practice address
119 N. 6TH, OKEENE, OK 73763
(580) 822-4441
(580) 822-4431
Mailing address
PO BOX 1218, NICOMA PARK, OK 73066-1218
(405) 769-7990
(405) 769-7970
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0601
OK
Other
Enumeration date
12/13/2010
Last updated
08/11/2011
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