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PHOENIX HEALTH CARE LLC NPI 1972518835


NPI Information

NPI: 1972518835
Provider Name: PHOENIX HEALTH CARE LLC

Doing Business As: SOUTH PARK EAST

Classification: Alzheimer Center (Dementia Center) - 311500000X
Entity Type: Organization

CLIA Number: 37D0974677

Address:
225 SW 35TH ST
OKLAHOMA CITY, OK
ZIP 73109
Phone: (405) 631-7444
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PHOENIX HEALTH CARE LLC is an alzheimer center dementia center in Oklahoma City, OK. The provider is a freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. PHOENIX HEALTH CARE LLC NPI is 1972518835. The provider is registered as an organization entity type.
The provider Is Doing Business As South Park East.

The provider's business location address is:

225 SW 35TH ST
OKLAHOMA CITY, OK
ZIP 73109-807
Phone: (405) 631-7444
Fax: (405) 631-1230

The provider's authorized official is Chrystal West .
The authorized official title is Business Office Manager and has the following contact phone number (405) 631-7444.

The CLIA number assigned to this NPI record is 37D0974677 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2006 and was last updated on 8/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311500000XAlzheimer Center (Dementia Center)NH5534-5534OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200040930CMEDICAIDOKLAHOMA
2375452MEDICARE OSCAR/CERTIFICATIONOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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