Provider Demographics
NPI:1134134984
Name:WCR ENTERPRISES INC
Entity Type:Organization
Organization Name:WCR ENTERPRISES INC
Other - Org Name:ENGLISH VILLAGE MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-477-1133
Mailing Address - Street 1:1515 CANTERBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-4917
Mailing Address - Country:US
Mailing Address - Phone:580-477-1133
Mailing Address - Fax:580-477-1136
Practice Address - Street 1:1515 CANTERBURY BLVD
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-4917
Practice Address - Country:US
Practice Address - Phone:580-477-1133
Practice Address - Fax:580-477-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH33023302313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100775370AMedicaid
OK375404Medicare Oscar/Certification