Healthcare Provider Details

I. General information

NPI: 1225496706
Provider Name (Legal Business Name): AMBASSADOR OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 WILL ROGERS PKWY SUITE 300
OKLAHOMA CITY OK
73108-1826
US

IV. Provider business mailing address

1340 E 61ST ST
TULSA OK
74136-0605
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-1144
  • Fax: 406-639-2742
Mailing address:
  • Phone: 918-743-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MIKE DIMOND
Title or Position: MANAGER
Credential:
Phone: 405-943-1144