| NPI | 1225094766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ALLEN HAYNES Mds/Cpc 918-485-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK NH7302-7302) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2020-08-22 |