Organization
POTEAU NURSING CENTER, LLC
Active
Other names
The Oaks Healthcare Center, The Oaks Health Care Center Poteau
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LIETZKE (CEO)
(918) 622-4799
Entity
Organization
Contact information
Practice address
1501 CLAYTON AVE, POTEAU, OK 74953-4102
(918) 647-8236
(918) 649-3747
Mailing address
1805 E 15TH ST, TULSA, OK 74104-4610
(918) 622-4799
(918) 622-4798
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH40094009
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375166001
BC/BS PROVIDEDR ID
OK
05
—
100847080A
—
OK
Enumeration date
10/20/2005
Last updated
08/26/2021
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