PHOENIX HEALTHCARE LLC (NPI# 1104830421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104830421 |
Entity Type | Organization |
Organization Name | PHOENIX HEALTHCARE LLC |
Other Organization Name | REST HAVEN NURSING CENTER |
Practice Address |
1944 N Iroquois Ave Tulsa OK 74106-4407 |
Practice Telephone | 9185831509 |
Practice Fax Number | 9185831804 |
Mailing Telephone | 9185831509 |
Mailing Fax Number | 9185831804 |
Enumeration Date | 2006-07-29 |
Last Update Date | 2008-08-08 |
Authorized Official Name | ANGELA MATTHEWS (MEDICARE SPECIALIST) |
Authorized Official Telephone | 9187433638 |
Is Organization Subpart | Y |
Parent Organization Name | PHOENIX HEALTHCARE LLC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | NH7221 | OK | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 200040930H | 05 |
Other Name | Type Code |
---|---|
Rest Haven Nursing Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356454094 | Phoenix Healthcare LLC | Nursing Facility/Intermediate Care Facility | 1503 Har-ber Rd, Grove, OK 74344-3525 | 2006-08-16 |
1780694711 | Phoenix Healthcare LLC | Nursing Facility/Intermediate Care Facility | 1165 S. Brenner Rd, Sapulpa, OK 74066-6141 | 2006-08-09 |
1740296490 | Phoenix Healthcare LLC | Skilled Nursing Facility | 3601 N Columbia Ave, Tulsa, OK 74110-1232 | 2006-08-01 |
1891700761 | Phoenix Healthcare LLC | Skilled Nursing Facility | 5701 W Britton Rd, Oklahoma City, OK 73132-2402 | 2006-07-29 |
1366493066 | Phoenix Healthcare LLC | Skilled Nursing Facility | 1235 Yancey St, Roanoke, AL 36274-2141 | 2006-05-15 |
1780687590 | Phoenix Healthcare LLC | Skilled Nursing Facility | 10912 E 14th St, Tulsa, OK 74128-4845 | 2005-05-24 |
1275712002 | Phoenix Healthcare LLC | Skilled Nursing Facility | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2007-10-29 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Phoenix Healthcare LLC | 52 Riley Road, #318, Celebration, FL 34747 |
North Carolina Corporations | Phoenix Healthcare LLC | 176 Mine Lake Court Suite 100, Raleigh, NC 27615-6417 |
Street Address |
1944 N IROQUOIS AVE |
City | TULSA |
State | OK |
Zip Code | 74106-4407 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811538895 | Desma Johnson | Technician | 784 East 43rd Street North, Tulsa, OK 74106 | 2019-10-01 |
1912462094 | Breyan Lashawn Jackson | Case Manager/Care Coordinator | 3606 N Mlk Jr. Blvd, Tulsa, OK 74106 | 2019-02-04 |
1740751445 | Ernest Kaara Maina | Family Medicine | 3606 M.l.k. Jr Blvd, Tulsa, OK 74106 | 2018-12-07 |
1568969632 | A&m Healthcare Clinic | Nurse Practitioner | 3606 North Mlk Blvd, Tulsa, OK 74106 | 2018-04-06 |
1265880819 | Paula Patricia Tullis | Psychologist | 1232 N Boston, Tulsa, OK 74106 | 2016-05-24 |
1326413030 | Eartha Mcalester | Counselor | 628 E. Virgin St., Tulsa, OK 74106 | 2015-12-07 |
1114334182 | James O Brannon Jr. | Behavioral Analyst | 2745 North Main, Tulsa, OK 74106 | 2014-07-22 |
1952718512 | Teresa Marie Williams | Counselor | 3601 N. Martin Luther King Blvd, Tulsa, OK 74106 | 2014-07-16 |
1639580764 | Lynnette Dixon | Case Management | 708 East 38th Street North, Tulsa, OK 74106 | 2014-05-12 |
1184975898 | Tiara Delonia | Social Worker | 1 W 36th St N Suite 1, Tulsa, OK 74106 | 2012-09-21 |
Find all providers in zip 74106 |
Taxonomy Code | 314000000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Skilled Nursing Facility |
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760748248 | Phoenix Rehab, LLC | Skilled Nursing Facility | 1021 Charles Page Blvd, Ste 200, Tulsa, OK 74127-8815 | 2012-04-09 |
1124226642 | Troy E Mcguire Jr. | Skilled Nursing Facility | 535 S Richmond Ave, Tulsa, OK 74112-4136 | 2007-07-05 |
1952444887 | Tulsa Christian Care Inc | Skilled Nursing Facility | 6201 E 36th St, Tulsa, OK 74135-5810 | 2007-02-14 |
1215013792 | Cox Retirement Properties Inc | Skilled Nursing Facility | 2552 E 21st St, Tulsa, OK 74114-1700 | 2006-10-27 |
1740296490 | Phoenix Healthcare LLC | Skilled Nursing Facility | 3601 N Columbia Ave, Tulsa, OK 74110-1232 | 2006-08-01 |
1700821493 | Oklahoma Methodist Manor Inc | Skilled Nursing Facility | 4134 E 31st St, Tulsa, OK 74135-1511 | 2006-06-18 |
1013958974 | Four Seasons Nursing Centers Inc | Skilled Nursing Facility | 2425 S Memorial Dr, Tulsa, OK 74129-2617 | 2006-06-09 |
1992750285 | Peak Medical Oklahoma No. 5, Inc. | Skilled Nursing Facility | 7707 S Memorial Dr, Tulsa, OK 74133-3643 | 2006-05-24 |
1497723621 | Cpc-sherwood Manor, Inc. | Skilled Nursing Facility | 2416 W 51st St, Tulsa, OK 74107-7700 | 2006-03-14 |
1831172857 | Skyline Heights Operating Co LLC | Skilled Nursing Facility | 6202 E 61st St, Tulsa, OK 74136-2119 | 2005-11-23 |
Find all providers in TULSA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.