Organization
HEARTSWORTH SENIOR LIVING, LLC
Active
Other names
Heartsworth House
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT PILGRIM (MANAGER)
(405) 285-8166
Entity
Organization
Contact information
Practice address
3325 FRENCH PARK DR, EDMOND, OK 73034-7277
(405) 285-8166
Mailing address
802 N BREWER ST, VINITA, OK 74301-1429
(405) 285-8166
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL1802
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL1802-1802
MEDICAID ADVANATGE WAIVER
OK
Enumeration date
01/13/2016
Last updated
01/13/2016
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