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General NPI Number Information
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NPI Number | 1184611972
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Entity Type | Organization
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Legal Business Name | TALIHINA MANOR LLC
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 301 EMMERT
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City | TALIHINA
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State | OK
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Zip | 74571
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Country | US
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Telephone | 918-567-2279
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Fax | 918-567-3239
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Provider Business Mailing Address
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Address Line | 301 EMMERT ST.
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City | TALIHINA
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State | OK
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Zip | 74571
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Country | US
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Telephone | 918-567-2279
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Fax |
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Authorized Official
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Title or Position | PRESIDETN
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Name | MICHAEL BRANDON MORGAN
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Credential |
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Telephone | 918-235-6443
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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 |
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License Number State | OK
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