Provider Demographics
NPI:1225506306
Name:EMERALD CARE CENTER CLAREMORE, LLC
Entity Type:Organization
Organization Name:EMERALD CARE CENTER CLAREMORE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAINDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-504-9797
Mailing Address - Street 1:2800 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-1086
Mailing Address - Country:US
Mailing Address - Phone:918-341-4365
Mailing Address - Fax:918-341-7218
Practice Address - Street 1:2800 HICKORY ST
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-1086
Practice Address - Country:US
Practice Address - Phone:918-341-4365
Practice Address - Fax:918-341-7218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility