CRESCENT MANOR INC. NPI 1205824463

NPI Information

  • NPI: 1205824463
  • Provider Name: CRESCENT MANOR INC.
  • Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
  • Entity Type: Organization
  • Doing Business As: CRESCENT CARE CENTER
  • CLIA Number: 37D2299988
  • Address: 208 E SANDERSON ST
    CRESCENT, OK
    ZIP 73028
  • Phone: (405) 696-2698

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NPI Details

CRESCENT MANOR INC. is a nursing facility intermediate care facility in Crescent, OK. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. CRESCENT MANOR INC. NPI is 1205824463. The provider is registered as an organization entity type.
The provider Is Doing Business As Crescent Care Center.

The provider's business location address is:

208 E SANDERSON ST
CRESCENT, OK
ZIP 73028-027
Phone: (405) 696-2698
Fax: (405) 969-2327

The provider's authorized official is Brandon Morgan .
The authorized official title is Ceo and has the following contact phone number (479) 769-5535.

The CLIA number assigned to this NPI record is 37D2299988 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2005 and was last updated on 1/24/2017.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care FacilityNH4202-4202OKLAHOMAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000375480001OTHEROKLAHOMABLUE CROSS BLUE SHIELD OK
2375480MEDICARE OSCAR/CERTIFICATIONOKLAHOMA
3200055460AMEDICAIDOKLAHOMA

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: 11/21/2025

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