Haskell Care Center LLC
Organization Active NPI Skilled Nursing Facility · Haskell, OK
NPI 1891795100 · NPPES record last updated Jan 6, 2025
Key facts
- NPI
- 1891795100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NH5104-5104 (OK)
- Legal business name
- HASKELL CARE CENTER LLC
- Practice address
- 405 N Choctaw Avenue
Haskell, OK 74436-1319 - Phone
- (918) 482-3310
- Fax
- (918) 482-6801
- NPI assigned
- Jul 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Pam Humphreys
- Title
- Owner
- Phone
- (405) 379-0039
Practitioners 1
-
Terry Hermance, MD
Medicare Care Compare: Nursing home
- Listed as
- Haskell Care Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 16, 2002
- Medicare certification status
- Active
- Certified beds
- 58 · 35.0 residents per day on average
- Penalties (3 years)
- 1 · fines totaling $3,422
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0957145 | Haskell Care Center, LLC | Certificate of waiver | Oct 25, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Skilled nursing facility certification: CCN 375414
- Legal name
- HASKELL CARE CENTER LLC
- Doing business as
- HASKELL CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 16, 2002
- Last certification
- Sep 27, 2024
- Beds
- 58
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 405 North Choctaw
Haskell, OK 74436-1319 - Nursing home name
- HASKELL CARE CENTER
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Linda Brannon |
Operational/Managerial Control | Dec 1, 2018 | |
| Adp of the SNF | Mar 10, 2025 | ||
| |
Adp of the SNF | Dec 11, 2025 | |
| Douglas Humphreys |
5% Or Greater Direct Ownership Interest |
Dec 1, 2000 | 5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090715000448 | OK | Part a Provider - Skilled Nursing Facility | 2961319991 | Practice locations: Haskell, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH5104-5104 | OK | Yes |
Addresses
Primary practice location
405 N Choctaw Avenue
Haskell, OK 74436-1319
Mailing address
405 N Choctaw Avenue
Haskell, OK 74436-1319
Phone (918) 482-3310
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100772190A | Medicaid | OK |
Other names
- haskell care center
Other providers in Haskell, OK
- Kara Enkey
- Claire L Erickson
- Taylor Jane Feller
- Fit for Me Physical Therapy, LLC
- Carol Harris
- Haskell Public Schools
- Linda Tracy, Otr/L, PC
- Ashwini Lingappa
- Love and Hope To2 Counseling Services PLLC
- Syreta Mason
All providers in Haskell, OK · Skilled Nursing 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 Jan 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.