Summit Healthcare Receivership LLC

Organization Active NPI Skilled Nursing Facility · Okeene, OK

NPI 1114220191 · NPPES record last updated Aug 11, 2011

Key facts

NPI
1114220191
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
NH0601 (OK)
Legal business name
SUMMIT HEALTHCARE RECEIVERSHIP LLC
Practice address
119 N. 6TH
Okeene, OK 73763
Phone
(580) 822-4441
Fax
(580) 822-4431
NPI assigned
Dec 13, 2010
Organization subpart
No

Authorized official

Name
Randy Goodman
Title
Receiver
Phone
(405) 769-7990

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0601 OK Yes

Addresses

Primary practice location

119 N. 6TH
Okeene, OK 73763

Mailing address

PO Box 1218
Nicoma Park, OK 73066-1218
Phone (405) 769-7990

Other providers in Okeene, OK

All providers in Okeene, OK · Skilled Nursing Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.