CRESTRIDGE LLC NPI 1639262702

NPI Details

CRESTRIDGE LLC is a nursing facility intermediate care facility in Watonga, 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. CRESTRIDGE LLC NPI is 1639262702. The provider is registered as an organization entity type.
The provider Is Doing Business As Crestridge Place.

The provider's business location address is:

816 N CLARENCE NASH BLVD
WATONGA, OK
ZIP 73772-024
Phone: (580) 623-7249
Fax: (580) 623-7245

The provider's authorized official is James Sims .
The authorized official title is Owner and has the following contact phone number (580) 822-4441.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 8/22/2020.

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: