Organization
PHOENIX HEALTH CARE, LLC
Active
Other names
Southern Oaks
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN A. FONDREN (ADMINISTRATOR)
(918) 762-2515
Entity
Organization
Contact information
Practice address
1401 4TH ST, PAWNEE, OK 74058-5003
(918) 762-2515
(918) 762-3704
Mailing address
1401 4TH ST, PAWNEE, OK 74058-5003
(918) 762-2515
(918) 762-3704
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH5902-5902
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200040930E
—
OK
Enumeration date
07/31/2006
Last updated
05/14/2026
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