Healthcare Provider Details

I. General information

NPI: 1689511206
Provider Name (Legal Business Name): HC SNF OPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 ANTES ST
HENRYETTA OK
74437
US

IV. Provider business mailing address

1305 SE ADAMS ST
IDABEL OK
74745-5240
US

V. Phone/Fax

Practice location:
  • Phone: 918-652-8797
  • Fax:
Mailing address:
  • Phone: 580-286-1065
  • Fax: 580-286-3926

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: KATHY S BAUCOM
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 479-312-8280