Organization
PAULS VALLEY CARE CENTER LLC
Active
Other names
Pauls Valley Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BART REED (MANAGER)
(580) 436-0950
Entity
Organization
Contact information
Practice address
1413 S CHICKASAW ST, PAULS VALLEY, OK 73075-6415
(405) 238-6411
Mailing address
1413 S CHICKASAW ST, PAULS VALLEY, OK 73075-6415
(405) 238-6411
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH2504-2504
OK
314000000X
Skilled Nursing Facility
Primary
NH2504-2504
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778860A
—
OK
Enumeration date
08/20/2009
Last updated
04/07/2020
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