Healthcare Provider Details

I. General information

NPI: 1013232800
Provider Name (Legal Business Name): PF LAWTON SNF OPS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7604 NW QUANAH PARKER TRAILWAY
LAWTON OK
73505-1155
US

IV. Provider business mailing address

1500 WATERS RIDGE DR STE 200
LEWISVILLE TX
75057-6056
US

V. Phone/Fax

Practice location:
  • Phone: 580-536-2866
  • Fax:
Mailing address:
  • Phone: 214-725-2837
  • Fax: 469-312-3796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNF 1605
License Number StateOK

VIII. Authorized Official

Name: JAMES M CHANCE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 214-725-2837