Healthcare Provider Details

I. General information

NPI: 1124970272
Provider Name (Legal Business Name): OKLAHOMA HEALTHCARE OPCO 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 LAKE MURRAY DR E
ARDMORE OK
73401-3851
US

IV. Provider business mailing address

6202 E 61ST ST
TULSA OK
74136-2119
US

V. Phone/Fax

Practice location:
  • Phone: 516-276-0556
  • Fax:
Mailing address:
  • Phone: 516-276-0556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: YEHUDAH J NEWMAN
Title or Position: MEMBER
Credential:
Phone: 516-276-0556