Provider Demographics
NPI:1093831422
Name:CLEVELAND HEALTHCARE PROPERTIES, LLC
Entity Type:Organization
Organization Name:CLEVELAND HEALTHCARE PROPERTIES, LLC
Other - Org Name:CLEVELAND AREA HOSPITAL SWINGBED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-358-2501
Mailing Address - Street 1:1401 W PAWNEE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020-3033
Mailing Address - Country:US
Mailing Address - Phone:918-358-2501
Mailing Address - Fax:918-392-1995
Practice Address - Street 1:1401 W PAWNEE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OK
Practice Address - Zip Code:74020-3033
Practice Address - Country:US
Practice Address - Phone:918-358-2501
Practice Address - Fax:918-392-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200049110CMedicaid
OK000370140001OtherBCBS OKLAHOMA
OK200049110CMedicaid
OK=========OtherTAX ID