Organization
BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA INC
Active
Parent organization
BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA INC
Other names
T.B. LACKEY HEALTH CARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA INC
Authorized official
MR. WENDELL J SHORT (VP PLANNING & PROJECT MANAGEMENT)
(405) 942-3000
Entity
Organization
Contact information
Practice address
9700 MASHBURN BLVD, OKLAHOMA CITY, OK 73162-5509
(405) 721-2466
(405) 721-0668
Mailing address
300 JOHNNY BENCH DR STE 400, OKLAHOMA CITY, OK 73104-2470
(405) 724-2872
(405) 721-0668
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
CC55015501
OK
314000000X
Skilled Nursing Facility
CC55015501
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100774330A
—
OK
Enumeration date
05/24/2005
Last updated
09/11/2025
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