Organization
ELK CITY NURSING HOME LLC
Active
Other names
elk city nursing center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX WADE DOUT (MANAGER)
(918) 333-9545
Entity
Organization
Contact information
Practice address
301 GARRETT, ELK CITY, OK 73648-3113
(580) 225-2811
Mailing address
301 GARRETT ST, ELK CITY, OK 73644-3113
(580) 225-2811
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0503-0503
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100771120A
—
OK
Enumeration date
07/13/2009
Last updated
10/28/2009
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