Organization
CITY OF SAPULPA
Active
Parent organization
CITY OF SAPULPA
Other names
Beacon Ridge Nursing Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY OF SAPULPA
Authorized official
BILL BUSH (CFO)
(405) 285-8166
Entity
Organization
Contact information
Practice address
102 E LINE AVE, SAPULPA, OK 74066-2858
(918) 216-1811
Mailing address
PO BOX 990, EDMOND, OK 73083-0990
(405) 285-8166
(405) 563-9447
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1902
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NH1902
LICENSE
OK
Enumeration date
08/31/2017
Last updated
08/31/2017
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