Legacy Living Centers

LBN: Forth Worth Manor Inc
Legacy Living Centers is an health care organization with primary practice located at 110 W Muskogee Ave , Sulphur OK 73086-4810. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Forth Worth Manor Inc can be contacted via phone (580) 622-6300, or through Pita, Janice via phone (580) 622-6300.

Contact Information

Primary practice address
110 W Muskogee Ave Sulphur OK 73086-4810
Phone: (580) 622-6300
Fax: (580) 622-8344
Website:
Map and Directions
Authorized official contact:
Name: Pita, Janice
Phone: (580) 622-6300

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 113559 Texas

Profile Details

NPI number 1891782298
LBN Legal business name Forth Worth Manor Inc
DBA Doing business as Legacy Living Centers
Authorized official Pita, Janice
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2005
Last updated Jun 16th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891782298 NPPES
Texas Other HH320S BLUE CROSS BLUE SHIELD
Texas MEDICAID 001012189 BLUE CROSS BLUE SHIELD

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