Organization
COLONIAL PLAZA MANAGEMENT COMPANY LLC
Active
Other names
Linwood Village Nursing and Retirement
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOB G POPE C.O.O (MEMBER)
(918) 743-7838
Entity
Organization
Contact information
Practice address
530 S LINWOOD AVE, CUSHING, OK 74023-4644
(918) 225-2220
(918) 225-4447
Mailing address
530 S LINWOOD AVE, CUSHING, OK 74023-4644
(918) 743-7838
(918) 748-5970
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH6001-6001
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20119150A
—
OK
Enumeration date
02/14/2007
Last updated
12/02/2015
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