Organization
BLUE RIVER HEALTHCARE INC.
Active
Other names
Hillcrest Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VETRESS MAE HOLT (ADMINISTRATOR)
(580) 371-2636
Entity
Organization
Contact information
Practice address
1105 E MAIN ST, TISHOMINGO, OK 73460-2401
(580) 371-2636
(580) 371-3890
Mailing address
PO BOX 157, TISHOMINGO, OK 73460-0157
(580) 371-2636
(580) 371-3890
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH35013501
OK
Other
Enumeration date
09/27/2006
Last updated
08/22/2020
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