| NPI | 1669677548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H STOUT Owner 405-399-2294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK 200111500A) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |