Organization
PEAK MEDICAL OKLAHOMA NO. 10, INC.
Active
Parent organization
SUNBRIDGE HEALTHCARE CORPORATION
Other names
Seminole Care and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE HEALTHCARE CORPORATION
Authorized official
WILLIAM A. MATHIES (PRESIDENT DIRECTOR)
(505) 821-3355
Entity
Organization
Contact information
Practice address
1200 E. WRANGLER BLVD., SEMINOLE, OK 74868-3595
(405) 382-1127
(405) 382-1129
Mailing address
101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH67066706
OK
314000000X
Skilled Nursing Facility
Primary
NH67066706
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100779150A
—
OK
Enumeration date
06/08/2006
Last updated
09/28/2009
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