Organization
GIPSON AND BASE AT WILLOW HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BASE (RECEIVER)
(405) 447-3000
Entity
Organization
Contact information
Practice address
1301 N 5TH ST, TONKAWA, OK 74653-1513
(580) 628-2529
Mailing address
114 S PETERS AVE, NORMAN, OK 73069-6034
(405) 447-3000
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
OK
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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