CRESTRIDGE LLC (NPI# 1639262702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639262702 |
| Entity Type | Organization |
| Organization Name | CRESTRIDGE LLC |
| Other Organization Name | CRESTRIDGE PLACE |
| Practice Address |
816 N Clarence Nash Blvd Watonga OK 73772-2024 |
| Mailing Address |
Po Box 727 Okeene OK 73763-0727 |
| Practice Telephone | 5806237249 |
| Practice Fax Number | 5806237245 |
| Mailing Telephone | 5808224441 |
| Mailing Fax Number | 5808224431 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES SIMS (OWNER) |
| Authorized Official Telephone | 5808224441 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | NH0603-0603 | OK | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Crestridge Place | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | CRESTRIDGE LLC | 816 N Clarence Nas Blvd, Watonga, OK 73772 |
| Street Address |
816 N CLARENCE NASH BLVD |
| City | WATONGA |
| State | OK |
| Zip Code | 73772-2024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225546815 | Sabrina Marie Yoder | Case Manager/Care Coordinator | 115 East 1st Street, Watonga, Ok, OK 73772 | 2018-01-17 |
| 1285150847 | Miriam Vaughan | Community Health Worker | 115 1/2 E 1st St, Watonga, OK 73772 | 2017-08-16 |
| 1053697649 | Marlin R Giles | Community/Behavioral Health | 403 Clarence Nash, Watonga, OK 73772 | 2011-10-26 |
| 1174811681 | Matthew Giles | Community/Behavioral Health | 1114 Villa Dr., Watonga, OK 73772 | 2011-07-18 |
| 1003127937 | Linda Jolane Scott | Counselor | 115 E. 1st Street, Watonga, OK 73772 | 2010-06-25 |
| 1063686764 | Brianna Auge | Counselor | 214 'a' Street, Watonga, OK 73772 | 2008-04-15 |
| 1770778417 | Jaycif A Justice | Social Worker | 216 W 'a' St., Watonga, OK 73772 | 2007-09-06 |
| 1609938984 | Flauryse M Baguidy | Dentist | Rr 1 Hwy 281 South, Usphs Ihs Watonga Health Center, Watonga, OK 73772 | 2006-12-14 |
| 1437603768 | City of Watonga | Ambulance | 305 W Main, Watonga, OK 73772 | 2016-08-03 |
| 1982976742 | Richard Zielinski Md, Pllc | Psychiatry & Neurology | 712 W 3rd St, Watonga, OK 73772 | 2012-02-08 |
| Find all providers in zip 73772 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455696 | Global Higher Call Nursing, LLC | Nursing Facility/Intermediate Care Facility | 407 Whitebird St, Quapaw, OK 74363-0912 | 2020-07-23 |
| 1336641786 | Sherri Geanette Hilburn | Nursing Facility/Intermediate Care Facility | 225 N. Broadway, Carnegie, OK 73015 | 2018-03-01 |
| 1750891149 | Anadarko Nursing & Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 300 West Washington, Anadarko, OK 73005 | 2017-10-11 |
| 1659773778 | First Choice Home Medical Inc | Nursing Facility/Intermediate Care Facility | 720 N Galena Ave, Geary, OK 73040-1501 | 2014-09-19 |
| 1467852244 | Jlg Healthcare LLC | Nursing Facility/Intermediate Care Facility | 811 W Elk, Duncan, OK 73533-1196 | 2014-08-28 |
| 1720326622 | Integris Rehab LLC | Nursing Facility/Intermediate Care Facility | 14145 S 220th East Ave, Coweta, OK 74429-6269 | 2013-01-28 |
| 1053617761 | Colonial Park Healthcare Center LLC | Nursing Facility/Intermediate Care Facility | 600 W Frontage Rd, Okemah, OK 74859-6433 | 2011-01-28 |
| 1851562136 | Thomas Health and Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 601 East Frisco Street, Thomas, OK 73669 | 2008-03-14 |
| 1770768566 | Cox Building Company, Inc. | Nursing Facility/Intermediate Care Facility | 3501 W Washington St, Broken Arrow, OK 74012-9196 | 2007-12-31 |
| 1477745834 | Rehabcare | Nursing Facility/Intermediate Care Facility | 300 Rockefeller, Muskogee, OK 74401-5235 | 2007-08-09 |
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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.