Organization
ELMWOOD MANOR NURSING HOME LLC
Active
Other names
ELMWOOD MANOR NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
PAM HUMPHREYS (OWNER)
(405) 379-0039
Entity
Organization
Contact information
Practice address
300 S SEMINOLE AVE, WEWOKA, OK 74884-2557
(405) 257-6621
(405) 257-6402
Mailing address
PO BOX 975, WEWOKA, OK 74884-0975
(405) 257-6621
(405) 257-6402
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH6701-6701
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200047510A
—
OK
Enumeration date
07/28/2005
Last updated
01/06/2025
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