MEDICARE: AMBASSADOR MANOR NURSING CENTER L.L.C.

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	314000000X	Skilled Nursing Facility	NH72017201	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609874528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBASSADOR MANOR NURSING CENTER L.L.C.

Provider Business Mailing Address
First Line	:	1340 E 61ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-0605
Country	:	US
Telephone Number	:	918-743-8978
Fax Number	:	918-749-5841

Provider Business Practice Location Address
First Line	:	1340 E 61ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-0605
Country	:	US
Telephone Number	:	918-743-8978
Fax Number	:	918-749-5841

Authorized Official
Title or Position	:	CFO
Name	:	MRS. BEVERLY LATIMER
Credential	:
Telephone Number	:	918-743-8978

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	09/08/2008

Similar Medicare Providers

1225496706 — AMBASSADOR OPERATIONS LLC
Practice Location Address:

4350 WILL ROGERS PKWY , SUITE 300
OKLAHOMA CITY, OK
73108-1826

Practice Phone: 405-943-1144
Practice Fax: 406-639-2742

1023182771 — YEN M TRAN MD INC
Practice Location Address:

6565 S YALE AVE , SUITE 610
TULSA, OK
74136-8378

Practice Phone: 918-502-2200
Practice Fax: 918-502-2210

1508817933 — DR. YEN MY TRAN M.D.
Practice Location Address:

6565 S YALE AVE STE 610
TULSA, OK
74136-8307

Practice Phone: 918-556-6500
Practice Fax: 918-382-1533

1770640856 — DR. ZEGUANG REN MD
Practice Location Address:

6475 S YALE AVE STE 308
TULSA, OK
74136-7802

Practice Phone: 918-499-4000
Practice Fax: 918-499-4001

1649347352 — CATHERINE CLAYBROOK MSW
Practice Location Address:

6506 S LEWIS AVE STE 105
TULSA, OK
74136-1020

Practice Phone: 918-205-3031
Practice Fax:

1316364789 — HALLIE MSONGAMWANJA LPC
Practice Location Address:

6506 S LEWIS AVE STE 105
TULSA, OK
74136-1020

Practice Phone: 918-212-4799
Practice Fax:

Directions to “AMBASSADOR MANOR NURSING CENTER L.L.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.