MEDICARE: SOMMERSET ASSISTED LIVING RESIDENCES, L.L.P.

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	302R00000X	Health Maintenance Organization	AL1402-1402	OK

General Provider Information

NPI Number	:	1568597029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMMERSET ASSISTED LIVING RESIDENCES, L.L.P.

Provider Business Mailing Address
First Line	:	1601 SW 119TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-4902
Country	:	US
Telephone Number	:	405-691-9221
Fax Number	:	405-691-9253

Provider Business Practice Location Address
First Line	:	1601 SW 119TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-4902
Country	:	US
Telephone Number	:	405-691-9221
Fax Number	:	405-691-9253

Authorized Official
Title or Position	:	OWNER
Name	:	CONNIE BAILEY
Credential	:	RN
Telephone Number	:	405-691-9221

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	08/22/2020

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