Crestridge LLC

Nursing Facility/Intermediate Care Facility · Watonga, OK

Organization Active NPI

NPI number 1639262702

Practice location

816 N Clarence Nash Blvd
Watonga, OK 73772-2024

Phone: (580) 623-7249
Fax: (580) 623-7245

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NPI record

NPI: 1639262702
Entity type: Organization (Type 2)
Enumeration date: October 2, 2006
Last updated: August 22, 2020
Organization subpart: No

Specialties & taxonomy codes

Taxonomy	Code	License	State
Nursing Facility/Intermediate Care Facility Primary	`313M00000X`	NH0603-0603	OK

Mailing address

PO Box 727
Okeene, OK 73763-0727

Phone: (580) 822-4441
Fax: (580) 822-4431

Authorized official

Name: James Sims
Title: Owner
Phone: (580) 822-4441

Other names

Crestridge Place

About Crestridge LLC

Crestridge LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Nursing Facility/Intermediate Care Facility (code 313M00000X). The practice location is 816 N Clarence Nash Blvd, Watonga, OK 73772-2024. The NPI number 1639262702 was assigned on October 2, 2006 and the record was last updated on August 22, 2020.

Crestridge LLC lists a license in the registry: #NH0603-0603 (OK) for Nursing Facility/Intermediate Care Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is James Sims, Owner.

Frequently asked questions

What is the NPI number of Crestridge LLC?

The NPI number is 1639262702.

What is the phone number of Crestridge LLC?

The phone number listed for the practice location is (580) 623-7249.

Where is Crestridge LLC located?

816 N Clarence Nash Blvd, Watonga, OK 73772-2024.

What is the taxonomy code for Crestridge LLC?

The primary taxonomy code is 313M00000X – Nursing Facility/Intermediate Care Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.