NPI 1417675471 · live from the CMS NPI Registry
Beacon Ridge Snf Operations LLC
Skilled Nursing Facility in Sapulpa, OK. National Provider Identifier 1417675471, active.
NPI record
| NPI | 1417675471 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 102 E Line Ave, Sapulpa, OK 74066 |
| Practice phone | 918-216-1811 |
| Enumerated | August 16, 2022 |
| Last updated | January 5, 2023 |
| Authorized official | David Ganz, Manager |
| Other names | Beacon Ridge |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.