| NPI | 1912099631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED RUCKER Administrator 918-743-7838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK NH7209-7209) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: OK NH7209-7209) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |