Organization
WEATHERFORD HEALTH SERVICES, LLC
Active
Other names
Weatherford Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCHUYLER MONTGOMERY (OWNER)
(918) 683-9407
Entity
Organization
Contact information
Practice address
2200 LYLE RD, WEATHERFORD, OK 73096-2912
(580) 774-1235
(580) 774-1258
Mailing address
1929 BETTY JANE LN, MUSKOGEE, OK 74403-1581
(918) 683-9407
(918) 683-1979
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH20052005
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200055120A
—
OK
Enumeration date
06/18/2006
Last updated
08/25/2008
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