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General NPI Number Information
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NPI Number | 1720897978
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Entity Type | Organization
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Legal Business Name | B & H OPERATIONS TAHLEQUAH LLC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1380 N HERITAGE LN
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City | TAHLEQUAH
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State | OK
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Zip | 74464-2136
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Country | US
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Telephone | 918-456-7117
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 MADISON 2035
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City | HUNTSVILLE
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State | AR
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Zip | 72740-8786
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AGENT
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Name | TARA BOX
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Credential |
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Telephone | 479-738-8717
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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 |
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