Healthcare Provider Details

I. General information

NPI: 1831663780
Provider Name (Legal Business Name): WARR ACRES OPERATING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 N MACARTHUR BLVD
OKLAHOMA CITY OK
73132-6505
US

IV. Provider business mailing address

3325 FRENCH PARK DR STE 6
EDMOND OK
73034-7265
US

V. Phone/Fax

Practice location:
  • Phone: 405-721-5444
  • Fax:
Mailing address:
  • Phone: 405-285-8166
  • Fax: 405-563-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: LEE PILGRIM
Title or Position: MEMBER
Credential:
Phone: 405-285-8166