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Organization

OK4 EASTGATE OPCO LLC

Active
Other names
Eastgate Village Retirement Center
Organization subpart
No

Provider details

NPI number
Authorized official
ISAAC DOLE (MANAGER/PRINCIPAL)
(773) 645-9246
Entity
Organization

Contact information

Practice address
3500 HASKELL BLVD, MUSKOGEE, OK 74403-3915
(918) 682-3191
Mailing address
3500 HASKELL BLVD, MUSKOGEE, OK 74403-3915
(918) 682-3191

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OK

Other

Enumeration date
05/03/2016
Last updated
10/29/2024
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