Organization
CEDAR HOLDING, LLC
Active
Other names
Cedar Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH K. KELSOE (ASSISTANT ADMINISTRATOR)
(918) 473-5598
Entity
Organization
Contact information
Practice address
1001 W GENTRY AVE, CHECOTAH, OK 74426-2046
(918) 473-2247
Mailing address
PO BOX 429, CHECOTAH, OK 74426-0429
(918) 473-2247
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH 4601-4601
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NH 4601-4601
—
OK
Enumeration date
02/14/2006
Last updated
08/22/2020
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