Bedlam Properties, LLC

Organization Active NPI Nursing Facility/Intermediate Care Facility · Blackwell, OK

NPI 1952390163 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1952390163
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
NH36013601 (OK)
Legal business name
BEDLAM PROPERTIES, LLC
Practice address
1315 S 11TH St
Blackwell, OK 74631-4613
Phone
(580) 363-1624
Fax
(580) 363-3977
NPI assigned
Oct 19, 2005
Organization subpart
No

Authorized official

Name
Mr. Jeffrey W Young
Title
Member/Manager
Phone
(918) 622-4799

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Bedlam Properties LLC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NH36013601 OK Yes

Addresses

Primary practice location

1315 S 11TH St
Blackwell, OK 74631-4613

Mailing address

4500 S Garnett Rd
Suite 610
Tulsa, OK 74146-5229
Phone (918) 622-4799

Other names

  • Blackwell Nursing Home Doing business as

Other providers in Blackwell, OK

All providers in Blackwell, OK · Nursing Facility/Intermediate Care Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.