Healthcare Provider Details

I. General information

NPI: 1548037641
Provider Name (Legal Business Name): BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 N OAKWOOD RD
ENID OK
73703-9344
US

IV. Provider business mailing address

300 JOHNNY BENCH DR STE 400
OKLAHOMA CITY OK
73104-2470
US

V. Phone/Fax

Practice location:
  • Phone: 580-249-2600
  • Fax:
Mailing address:
  • Phone: 405-724-2872
  • Fax: 405-942-0018

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: WENDELL J SHORT
Title or Position: VICE PRESIDENT
Credential:
Phone: 405-942-3000