Healthcare Provider Details

I. General information

NPI: 1881557007
Provider Name (Legal Business Name): BV OK OPCO 1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6202 E 61ST ST
TULSA OK
74136-2119
US

IV. Provider business mailing address

6202 E 61ST ST
TULSA OK
74136-2119
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-8830
  • Fax:
Mailing address:
  • Phone: 918-494-8830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YEHUDAH NEWMAN
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 917-807-2144