Organization
LATIMER LONG TERM CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN TIDWELL DPH (OWNER)
(918) 465-9300
Entity
Organization
Contact information
Practice address
103 SW 9TH ST, WILBURTON, OK 74578-3604
(918) 465-9300
Mailing address
225 W MAIN ST, WILBURTON, OK 74578-4045
(918) 465-9300
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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