Wolfe Living Center Association

Key facts

NPI: 1942392964
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
License: NH55485548 (OK)
Legal business name: WOLFE LIVING CENTER ASSOCIATION
Practice address: 18501 NE 63Rd St
Harrah, OK 73045-8550
Phone: (405) 454-1400
Fax: (405) 454-1404
NPI assigned: Sep 28, 2006
Organization subpart: No

Authorized official

Name: Martin Hubbertt
Title: Administrator
Phone: (405) 454-1400

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Dan Neal Waters, MD Family Medicine Physician · Oklahoma City, OK · NPI 1750341012

CMS ownership ADP OF THE SNF

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Dan Neal Waters, MD Family Medicine Physician · Oklahoma City, OK · NPI 1750341012

NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Dan Neal Waters, MD Family Medicine Physician · Oklahoma City, OK · NPI 1750341012

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: The Wolfe Living Center at Summit Ridge CCN 375472
Overall star rating: ★★★☆☆ 3 of 5
Health inspections: ★★★☆☆ 3 of 5
Staffing: ★★★☆☆ 3 of 5
Quality measures: ★★☆☆☆ 2 of 5
Type: Medicare and Medicaid
Ownership: Non profit - Church related
Certified: Jan 1, 2005
Medicare certification status: Active (Provider of Services file)
Certified beds: 48 · 36.6 residents per day on average

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
37D0929736	Wolfe Living Center at Summit Ridge 18501 NE 63Rd Street, Harrah, OK 73045	Certificate of waiver	Jun 22, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK

Skilled nursing facility certification: CCN 375472

Legal name: WOLFE LIVING CENTER ASSOCIATION
Doing business as: THE WOLFE LIVING CENTER AT SUMMIT RIDGE
Certification status: Active
Provider type (POS): Nursing home – SNF/NF dual certification
Participating since: Jan 1, 2005
Last certification: Apr 1, 2025
Beds: 48
Ownership / control type: Church Related
Most recent change of ownership: Jul 1, 2007
Organization structure: Corporation · Non-profit
Incorporated: Dec 22, 2006 in OK
Enrollment address: 18501 NE 63Rd St
Harrah, OK 73045-8550
Nursing home name: THE WOLFE LIVING CENTER AT SUMMIT RIDGE

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Name	Role	Since	Share
Dan Neal Waters Individual	Adp of the SNF	Apr 29, 2025
Ernest Johnson Individual	Corporate Director	Jan 1, 2001
Steve Vogel Individual	Corporate Director	Jan 1, 2023
Charlene Vanvliet Individual	Corporate Director	Jan 1, 2007
Wolfe Living Center Association Organization · Harrah, OK Non-profit	5% Or Greater Direct Ownership Interest	Jul 1, 2007	100%
Rowena Davidson Individual	Corporate Officer	Jan 1, 2021
Carlos Portanova Individual	Corporate Officer Treasurer	Sep 1, 2019
Elevate Senior Living, LLC Organization · Ooltewah, TN LLC	Adp of the SNF	Apr 1, 2021
Dawnita L Lawless Individual	Corporate Director Secretary	Jan 1, 2021
James Shires Individual	Corporate Director Chairperson	May 1, 2017
William Norman Individual	Corporate Officer	Jan 1, 2002
Myrta Beem Individual	Corporate Director	Oct 1, 2020
David Carey Individual	Corporate Director Administrator	Jan 3, 2023	100%
	Operational/Managerial Control	Jan 3, 2023
	Adp of the SNF	Apr 29, 2025
Derrell Dover Individual	Corporate Director	Jan 1, 2021
Jocelyn St. Pierre Individual	Corporate Director	Jan 1, 2021

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20070822001275	OK	Part a Provider - Skilled Nursing Facility	3476645409	Practice locations: Harrah, OK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X	NH55485548	OK	Yes

Addresses

Primary practice location

18501 NE 63Rd St
Harrah, OK 73045-8550

Mailing address

18501 NE 63Rd St
Harrah, OK 73045-8550
Phone (405) 454-1400

Other names

The Wolfe Living Center Doing business as

Other providers in Harrah, OK

All providers in Harrah, 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 Aug 22, 2020. 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.

Verify at the official NPI Registry.