Organization
WEWOKA NURSING HOME INC
Active
Other names
WEWOKA NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SMART (PRESIDENT)
(405) 380-6902
Entity
Organization
Contact information
Practice address
1400 W 1ST ST, WEWOKA, OK 74884-5006
(580) 436-0950
(580) 436-0953
Mailing address
131 N BROADWAY AVE, ADA, OK 74820-5003
(580) 436-0950
(580) 436-0953
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH6705-6705
OK
314000000X
Skilled Nursing Facility
Primary
NH6705-6705
OK
Other
Enumeration date
03/29/2011
Last updated
07/01/2011
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