Healthcare Provider Details

I. General information

NPI: 1013029255
Provider Name (Legal Business Name): BELLECREEK CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 24TH AVE SW
NORMAN OK
73069-3913
US

IV. Provider business mailing address

600 24TH AVE SW
NORMAN OK
73069-3913
US

V. Phone/Fax

Practice location:
  • Phone: 405-329-6771
  • Fax: 405-329-2676
Mailing address:
  • Phone: 405-329-6771
  • Fax: 405-329-2676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH 1409
License Number StateOK

VIII. Authorized Official

Name: MR. DAVID THOMPSON
Title or Position: SOLE MEMBER/MANAGER
Credential:
Phone: 405-879-0102