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General NPI Number Information
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NPI Number | 1073528816
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Entity Type | Organization
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Legal Business Name | BELLEVUE NORTHWEST NURSING CENTER, LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 6500 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-2035
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Country | US
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Telephone | 405-767-6500
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Fax | 405-767-6501
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Provider Business Mailing Address
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Address Line | 6500 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-2035
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Country | US
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Telephone | 405-767-6500
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Fax | 405-767-6501
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HEATHER GFELLER
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Credential |
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Telephone | 405-767-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH55025502
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License Number State | OK
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