Fountain View Manor, Inc

LBN: Fountain View Manor, Inc
Fountain View Manor, Inc is an health care organization with primary practice located at 107 E Barclay St , Henryetta OK 74437-5609. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center), Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Fountain View Manor, Inc can be contacted via phone (918) 652-7021, or through Clason, Jennifer Michelle via phone (918) 652-7021.

Contact Information

Primary practice address
107 E Barclay St Henryetta OK 74437-5609
Phone: (918) 652-7021
Fax: (918) 652-7216
Website:
Map and Directions
Authorized official contact:
Name: Clason, Jennifer Michelle LPN, NHADM.
Phone: (918) 652-7021

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X NH56035603 Oklahoma
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X NH56035603 Oklahoma
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 375462 Oklahoma

Profile Details

NPI number 1124026448
LBN Legal business name Fountain View Manor, Inc
DBA Doing business as
Authorized official Clason, Jennifer Michelle LPN, NHADM.
Entity Organization
Organization subpart 1 No
Enumeration date Jul 11th, 2005
Last updated Jun 20th, 2013 - about 13 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 1124026448 NPPES
Oklahoma MEDICAID 100773730A

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