Organization
EDNA LEE'S RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA J KELLEY (ADMINISTRATOR)
(918) 256-3131
Entity
Organization
Contact information
Practice address
421 W SOUTH AVE, VINITA, OK 74301-4143
(918) 256-3131
Mailing address
421 W SOUTH AVE, VINITA, OK 74301-4143
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
RC1806-1806
OK
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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