Organization
FOUNTAINS CANTERBURY SL, LLC
Active
Other names
The Fountains at Canterbury
Organization subpart
No
Provider details
NPI number
Authorized official
GRETA FRUHLING FRAZIER (DIRECTOR)
(520) 797-4000
Entity
Organization
Contact information
Practice address
1404 NW 122ND ST, OKLAHOMA CITY, OK 73114-8000
(405) 751-3600
(405) 751-6511
Mailing address
2020 W RUDASILL RD, ATTN: MEDICARE BILLING, TUCSON, AZ 85704-7800
(520) 797-4000
(520) 797-7757
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
CC5503-5503
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100777120A
—
OK
Enumeration date
05/03/2006
Last updated
06/29/2010
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