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General NPI Number Information
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NPI Number | 1265542617
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Entity Type | Organization
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Legal Business Name | SEQUOYAH EAST NURSING CENTER LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 701 S TAYLOR RD
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City | ROLAND
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State | OK
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Zip | 74954
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Country | US
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Telephone | 918-427-7401
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Fax | 918-427-6629
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Provider Business Mailing Address
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Address Line | 701 S TAYLOR RD
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City | ROLAND
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State | OK
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Zip | 74954
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Country | US
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Telephone | 918-427-7401
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Fax | 918-427-6629
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JUDY C DIGIACINTO
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Credential | ADM
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Telephone | 918-427-7401
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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 | NH68026802
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License Number State | OK
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