Healthcare Provider Details

I. General information

NPI: 1265429344
Provider Name (Legal Business Name): GREAT PLAINS CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 BEALL RD
KINGFISHER OK
73750-4800
US

IV. Provider business mailing address

905 BEALL RD.
KINGFISHER OK
74955
US

V. Phone/Fax

Practice location:
  • Phone: 405-375-6857
  • Fax: 405-375-6859
Mailing address:
  • Phone: 918-775-6200
  • Fax: 918-775-5643

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: MICHAEL BRANDON MORGAN
Title or Position: CEO
Credential:
Phone: 479-769-5535