Healthcare Provider Details

I. General information

NPI: 1427068923
Provider Name (Legal Business Name): K. & C. CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W 1ST ST
HEAVENER OK
74937-2062
US

IV. Provider business mailing address

204 W 1ST ST
HEAVENER OK
74937-2062
US

V. Phone/Fax

Practice location:
  • Phone: 918-653-2464
  • Fax:
Mailing address:
  • Phone: 918-653-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH4001-4001
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH4001-4001
License Number StateOK

VIII. Authorized Official

Name: MR. ARCHIE DON FARMER
Title or Position: OWNER
Credential:
Phone: 918-653-2464