Organization
AMBASSADOR MANOR NURSING CENTER L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY LATIMER (CFO)
(918) 743-8978
Entity
Organization
Contact information
Practice address
1340 E 61ST ST, TULSA, OK 74136-0605
(918) 743-8978
(918) 749-5841
Mailing address
1340 E 61ST ST, TULSA, OK 74136-0605
(918) 743-8978
(918) 749-5841
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH72017201
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100806180A
—
OK
05
—
100806180B
—
OK
Enumeration date
07/13/2005
Last updated
09/08/2008
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