Organization
STILWELL NURSING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANDIE HASTINGS (MANAGING MEMBER)
(405) 282-6285
Entity
Organization
Contact information
Practice address
509 W LOCUST ST, STILWELL, OK 74960-3644
(918) 696-7715
(918) 696-4638
Mailing address
PO BOX 1095, GUTHRIE, OK 73044-1095
(405) 282-6285
(405) 282-5731
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0101
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114540A
—
OK
Enumeration date
05/24/2007
Last updated
11/29/2019
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