Organization
24TH PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BART REED (MANAGER)
(580) 399-7920
Entity
Organization
Contact information
Practice address
600 24TH AVE SW, NORMAN, OK 73069-3913
(405) 747-6154
Mailing address
131 N BROADWAY AVE, ADA, OK 74820-5003
(580) 436-0950
(580) 436-0953
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1409-1409
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200102120A
—
OK
Enumeration date
08/30/2016
Last updated
01/20/2022
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