Organization
SEQUOYAH COUNTY CITY TRUST
Active
Other names
SMH Extended Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES E. WADE (CEO)
(918) 774-1100
Entity
Organization
Contact information
Practice address
213 E REDWOOD AVE, SALLISAW, OK 74955-2811
(918) 774-1100
(918) 774-1103
Mailing address
PO BOX 505, SALLISAW, OK 74955-0505
(918) 774-1100
(918) 774-1103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4028
OK
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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