=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518855204
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STURDY WINGS HEALTHCARE OF CHANDLER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2025
-----------------------------------------------------
Last Update Date | 06/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 W 1ST ST
-----------------------------------------------------
City | CHANDLER
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74834-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-785-7486
-----------------------------------------------------
Fax | 405-857-3177
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 62
-----------------------------------------------------
City | ENOLA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72047-0062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-499-6651
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. CATHY LYNN PARSONS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 501-499-6651
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------