Organization
HEARTWAY CORPORATION
Active
Other names
Memorial Heights Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY SUZETTE BAUCOM (REGIONAL DIRECTOR)
(580) 286-1065
Entity
Organization
Contact information
Practice address
1305 SE ADAMS ST, IDABEL, OK 74745
(580) 286-3366
(580) 286-3022
Mailing address
1305 SE ADAMS ST, IDABEL, OK 74745-5240
(580) 286-1065
(580) 286-3926
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH4504-4504
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778790A
—
OK
Enumeration date
01/03/2006
Last updated
02/16/2026
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