Organization
WILLOW CREEK HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANDIE HASTINGS (MANAGER)
(405) 282-6285
Entity
Organization
Contact information
Practice address
2300 W NOBLE AVE, GUTHRIE, OK 73044-5504
(405) 282-1686
(405) 282-5731
Mailing address
PO BOX 1095, GUTHRIE, OK 73044-1095
(405) 282-6285
(405) 282-5731
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH4201
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778230A
—
OK
Enumeration date
12/17/2009
Last updated
04/19/2012
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