| NPI | 1518297654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R BUSH Member 405-285-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OK NH1903) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK NH1903) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2020-06-05 |