Organization
HARTSHORNE HEALTH SERVICES, LLC
Active
Other names
Beare Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM M MONTGOMERY (OWNER)
(918) 683-9407
Entity
Organization
Contact information
Practice address
1300 NORTH DR, HARTSHORNE, OK 74547-4400
(918) 297-7000
(918) 297-3487
Mailing address
1929 BETTY JANE LN, MUSKOGEE, OK 74403-1581
(918) 683-9407
(918) 683-1979
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH61116111
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200055510A
—
OK
Enumeration date
06/24/2006
Last updated
11/13/2008
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