| NPI | 1912990110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY VERNON SIMMONS Manager 405-360-2562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK NH1403-1403) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2008-07-01 |