Ambassador Manor Nursing Center L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH72017201 Issued in OK

Legal business name

AMBASSADOR MANOR NURSING CENTER L.L.C.

Practice address

1340 E 61St St
Tulsa, OK 74136-0605

Phone

(918) 743-8978

Fax

(918) 749-5841

NPI assigned

Jul 13, 2005

Organization subpart

No

Name

Mrs. Beverly Latimer

Title

Cfo

Phone

(918) 743-8978

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 8, 2008.

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1609874528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741360605",
            "telephone_number": "918-743-8978",
            "fax_number": "918-749-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741360605",
            "telephone_number": "918-743-8978",
            "fax_number": "918-749-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR MANOR NURSING CENTER L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "LATIMER",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "918-743-8978",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH72017201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100806180A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100806180B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.