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Organization

SILVERCREST MANOR NURSING HOME INC

Active
Other names
Legacy Living Centers
Organization subpart
No

Provider details

NPI number
Authorized official
JANICE PITA (INSURANCE/MEDICARE)
(580) 622-6300
Entity
Organization

Contact information

Practice address
301 W WASHINGTON AVE, ANADARKO, OK 73005-2442
(405) 247-3346
(405) 247-5635
Mailing address
301 W WASHINGTON AVE, ANADARKO, OK 73005-2442
(405) 247-3346
(405) 247-5635

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH0805-0805
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000375477001
BLUE CROSS BLUE SHIELD OK
OK
05
200059970A
OK
Enumeration date
10/12/2005
Last updated
05/22/2008
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