<Unavail>

LBN: St John Villas Inc
<Unavail> is an health care organization with primary practice located at 17110 E 51St St , Broken Arrow OK 74012-9279. The organization recently has 2 registered licenses in different health care specialties including 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. St John Villas Inc can be contacted via phone (918) 355-1596, or through Anderson, Lex via phone (918) 744-3072.

Contact Information

Primary practice address
17110 E 51St St Broken Arrow OK 74012-9279
Phone: (918) 355-1596
Fax: (918) 355-1788
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Lex
Phone: (918) 744-3072

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X CC7207 Oklahoma
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 37-5525 Oklahoma

Profile Details

NPI number 1073682662
LBN Legal business name St John Villas Inc
DBA Doing business as <Unavail>
Authorized official Anderson, Lex
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2006
Last updated Feb 5th, 2009 - about 17 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 1073682662 NPPES
Oklahoma MEDICAID 100774850A

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