MEDICARE: CLEVELAND HEALTHCARE PROPERTIES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	2270	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000370140001	OTHER	OK	BCBS OKLAHOMA

General Provider Information

NPI Number	:	1568422509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND HEALTHCARE PROPERTIES, LLC

Provider Business Mailing Address
First Line	:	1401 W PAWNEE ST
Second Line	:
City	:	CLEVELAND
State	:	OK
Zip	:	74020-3033
Country	:	US
Telephone Number	:	918-358-2501
Fax Number	:	918-358-5526

Provider Business Practice Location Address
First Line	:	1401 W PAWNEE
Second Line	:
City	:	CLEVELAND
State	:	OK
Zip	:	74020
Country	:	US
Telephone Number	:	918-358-2501
Fax Number	:	918-358-5526

Authorized Official
Title or Position	:	CFO
Name	:	TINA STEELE
Credential	:
Telephone Number	:	918-358-2501

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	01/23/2009

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Directions to “CLEVELAND HEALTHCARE PROPERTIES, LLC ” Practice Location

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