Basic Information
| Provider Information | |||||||||
| NPI: | 1669677548 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OAK HILL CARE CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 GEORGIA ST | ||||||||
| Address2: | |||||||||
| City: | JONES | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730497556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053992294 | ||||||||
| FaxNumber: | 4053995037 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 GEORGIA ST | ||||||||
| Address2: | |||||||||
| City: | JONES | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730497556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053992294 | ||||||||
| FaxNumber: | 4053995037 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | STOUT | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4053992294 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | OK | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.