Organization
SOUTHERN HILLS REHAB CENTER, LLC
Active
Other names
SOUTHERN HILLS REHABILITATION CENTER, Heathcare Management of Oklahoma, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE BALLER (CEO)
(303) 449-2100
Entity
Organization
Contact information
Practice address
5170 S VANDALIA AVE, TULSA, OK 74135-4079
(918) 496-3963
(918) 496-0774
Mailing address
5170 S VANDALIA AVE, TULSA, OK 74135-4079
(918) 496-3963
(918) 496-0774
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200609790A
—
OK
05
—
200609790B
—
OK
Enumeration date
02/11/2015
Last updated
05/13/2021
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