| NPI | 1720897978 |
|---|---|
| Doing Business As | COUNTRYSIDE ASSISTED LIVING OF TAHLEQUAH |
| Entity Type | Organization |
| Authorized Contact | TARA BOX Agent 479-738-8717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-01-03 |