Healthcare Provider Details

I. General information

NPI: 1578741492
Provider Name (Legal Business Name): PF TNC SNF OPS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10912 E 14TH ST
TULSA OK
74128-4845
US

IV. Provider business mailing address

1500 WATERS RIDGE DR STE 100
LEWISVILLE TX
75057-6056
US

V. Phone/Fax

Practice location:
  • Phone: 918-438-2440
  • Fax: 918-437-3356
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 NumberNH72307230
License Number StateOK

VIII. Authorized Official

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