Organization
PSG - WILLOW PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL HANKINS (ADMINISTRATOR)
(580) 536-1279
Entity
Organization
Contact information
Practice address
7019 NW CACHE RD, LAWTON, OK 73505-2707
(580) 536-1279
(580) 510-0017
Mailing address
7019 NW CACHE RD, LAWTON, OK 73505-2707
(580) 536-1279
(580) 510-0017
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH1607-1607
OK
314000000X
Skilled Nursing Facility
NH 16071607
OK
Other
Enumeration date
06/21/2005
Last updated
09/11/2025
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