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General NPI Number Information
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NPI Number | 1285117150
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Entity Type | Organization
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Legal Business Name | SOUTHERN HILLS RETIREMENT CENTER, LLC
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 5170 S VANDALIA AVE
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City | TULSA
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State | OK
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Zip | 74135-4079
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Country | US
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Telephone | 918-496-3963
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Fax | 918-496-0774
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Provider Business Mailing Address
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Address Line | 5170 S VANDALIA AVE
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City | TULSA
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State | OK
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Zip | 74135-4079
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Country | US
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Telephone | 918-496-3963
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Fax | 918-496-0774
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Authorized Official
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Title or Position | MANAGER
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Name | ZVI RHINE
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Credential |
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Telephone | 423-877-2024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | OK
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