Organization
SOUTHWEST LTC TUTTLE LLC
Active
Other names
Tuttle Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD PAYNE (CEO)
(469) 916-6100
Entity
Organization
Contact information
Practice address
104 SE 4TH ST, TUTTLE, OK 73089-8825
(405) 381-3363
Mailing address
1518 LEGACY DR, SUITE 110, FRISCO, TX 75034-6038
(469) 916-6100
(469) 916-6105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200093870B
—
OK
Enumeration date
02/20/2015
Last updated
02/20/2015
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