Organization
COLES NURSING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANDIE HASTINGS (MEMBER)
(405) 282-6285
Entity
Organization
Contact information
Practice address
2300 W NOBLE AVE, GUTHRIE, OK 73044-5504
(405) 282-1686
(405) 282-1681
Mailing address
2300 W NOBLE AVE, GUTHRIE, OK 73044-5504
(405) 282-1686
(405) 282-1681
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH4201
OK
314000000X
Skilled Nursing Facility
Primary
NH4201
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778230A
—
OK
Enumeration date
07/21/2005
Last updated
05/13/2008
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