Corn the Mennonite Brethren Church of Corn Ok
Organization Active NPI Nursing Facility/Intermediate Care Facility · Corn, OK
NPI 1295798494 · NPPES record last updated Apr 5, 2010
Key facts
- NPI
- 1295798494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- NH7502 (OK)
- Legal business name
- CORN THE MENNONITE BRETHREN CHURCH OF CORN OK
- Practice address
- 106 W Adams Street
Corn, OK 73024 - Phone
- (580) 343-2295
- Fax
- (580) 343-2297
- NPI assigned
- Apr 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Martin Hall
- Title
- Executive Director
- Phone
- (580) 343-2295
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH7502 | OK | Yes |
Addresses
Primary practice location
106 W Adams Street
Corn, OK 73024
Mailing address
PO Box 98
Corn, OK 73024-0098
Phone (580) 343-2295
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100771430A | Medicaid | OK |
Other names
- Corn Heritage Village
Other providers in Corn, OK
All providers in Corn, OK · Nursing Facility/Intermediate Care Facility in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.