Healthcare Provider Details

I. General information

NPI: 1770829806
Provider Name (Legal Business Name): FOREST HILLS HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W HOUSTON ST
BROKEN ARROW OK
74012-4519
US

IV. Provider business mailing address

4300 W HOUSTON ST
BROKEN ARROW OK
74012-4519
US

V. Phone/Fax

Practice location:
  • Phone: 918-254-5000
  • Fax: 918-254-0346
Mailing address:
  • Phone: 918-254-5000
  • Fax: 918-254-0346

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: JUDAH BIENSTOCK
Title or Position: MANAGING MEMBER
Credential:
Phone: 314-812-2550