Healthcare Provider Details

I. General information

NPI: 1649267733
Provider Name (Legal Business Name): JAN FRANCES CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N COUNTRY CLUB RD
ADA OK
74820-2843
US

IV. Provider business mailing address

815 N COUNTRY CLUB RD
ADA OK
74820-2843
US

V. Phone/Fax

Practice location:
  • Phone: 580-332-5328
  • Fax: 580-332-2792
Mailing address:
  • Phone: 580-332-5328
  • Fax: 580-332-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH6203
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MICHAEL BRANDON MORGAN
Title or Position: PRESIDENT
Credential:
Phone: 918-235-6443