Countrywood Assisted Living & Memory Care, LLC
Organization Active NPI Point of Service · Kingfisher, OK
NPI 1306041272 · NPPES record last updated May 13, 2008
Key facts
- NPI
- 1306041272
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Point of Service 305S00000X
- Legal business name
- COUNTRYWOOD ASSISTED LIVING & MEMORY CARE, LLC
- Practice address
- 1604 S 13TH St
Kingfisher, OK 73750-4619 - Phone
- (405) 375-5232
- Fax
- (405) 375-5830
- NPI assigned
- Jun 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. John Holtz
- Title
- Controller
- Phone
- (541) 747-3373
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | Yes |
Addresses
Primary practice location
1604 S 13TH St
Kingfisher, OK 73750-4619
Mailing address
78 Centennial Loop
Eugene, OR 97401-7900
Phone (541) 747-3373
Other providers in Kingfisher, OK
- Mary Chance
- Chisholm Medical Equipment
- City of Kingfisher
- Compassion Clinic Pharmacy
- Jimmy Lee Couch
- Benjamin Nicolas Cuevas
- Kendra Lynn Daffern
- Jeffrey Carl Danner
- Amber Lisette Davis
- Theresa Ann Davis
All providers in Kingfisher, OK · Point of Service in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2008. 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.