Organization
LIGHTNING CREEK INVESTMENT GROUP INC
Active
Other names
MOORELAND HERITAGE MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS G. MADDUX (PRESIDENT)
(918) 273-3649
Entity
Organization
Contact information
Practice address
402 SE 6TH ST, MOORELAND, OK 73852-9064
(918) 273-3649
(918) 273-5652
Mailing address
PO BOX 468, NOWATA, OK 74048-0468
(918) 273-3649
(918) 273-5652
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH7702-7702
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100776120B
—
OK
Enumeration date
02/21/2007
Last updated
07/20/2010
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