NPI 1306041272

Countrywood Assisted Living & Memory Care, LLC

Organisation Point of Service Kingfisher, OK

Practice location

Address: 1604 S 13th St, Kingfisher, OK 73750-4619
Phone: (405) 375-5232
Fax: (405) 375-5830
Mailing address: 78 Centennial Loop, Eugene, OR 97401-7900

Authorised official

Name: John Holtz
Title: Controller
Phone: (541) 747-3373

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

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Registry record

NPI: 1306041272
Entity type: Organization
NPI issued: 19 Jun 2007
Record last updated: 13 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.