Tidwell Living Center

LBN: Tidwell Healthcare, Llc
Tidwell Living Center is an health care organization with primary practice located at 900 Ranchwood Dr , Wilburton OK 74578-3630. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Tidwell Healthcare, Llc can be contacted via phone (918) 465-5020, or through Tidwell, Melissa C via phone (918) 465-5020.

Contact Information

Primary practice address
900 Ranchwood Dr Wilburton OK 74578-3630
Phone: (918) 465-5020
Fax: (918) 465-5007
Website:
Map and Directions
Authorized official contact:
Name: Tidwell, Melissa C RN, MHA
Phone: (918) 465-5020

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X NH3903-3903 Oklahoma

Profile Details

NPI number 1023430741
LBN Legal business name Tidwell Healthcare, Llc
DBA Doing business as Tidwell Living Center
Authorized official Tidwell, Melissa C RN, MHA
Entity Organization
Organization subpart 1 No
Enumeration date Jan 15th, 2014
Last updated Dec 31st, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023430741 NPPES
Oklahoma MEDICAID 200522320A

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