NPI 1124026448 · live from the CMS NPI Registry
Fountain View Manor, INC
Skilled Nursing Facility in Henryetta, OK. National Provider Identifier 1124026448, active.
NPI record
| NPI | 1124026448 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 107 E Barclay St, Henryetta, OK 74437 |
| Practice phone | 918-652-7021 |
| Mailing address | 107 E Barclay St, P.O. Box 520, Henryetta, OK 74437 |
| Enumerated | July 11, 2005 |
| Last updated | June 20, 2013 |
| Authorized official | Jennifer Clason, Adm. |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Alzheimer Center (Dementia Center) | 311500000X | NH56035603 (OK) |
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH56035603 (OK) |
| Skilled Nursing Facility primary | 314000000X | 375462 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.