Provider Demographics
NPI:1043419781
Name:HOBART LIVING CENTERS, INC
Entity Type:Organization
Organization Name:HOBART LIVING CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BURL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:STRICKER
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:580-726-3381
Mailing Address - Street 1:709 N LOWE ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:OK
Mailing Address - Zip Code:73651-1642
Mailing Address - Country:US
Mailing Address - Phone:580-726-3381
Mailing Address - Fax:580-726-5043
Practice Address - Street 1:709 N LOWE ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:OK
Practice Address - Zip Code:73651-1642
Practice Address - Country:US
Practice Address - Phone:580-726-3381
Practice Address - Fax:580-726-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH38033803314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200125090AMedicaid
OK200125090AMedicaid