Provider Demographics
NPI:1326347519
Name:RECEIVER CARE LLC
Entity Type:Organization
Organization Name:RECEIVER CARE LLC
Other - Org Name:MCLOUD NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RECEIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-272-0511
Mailing Address - Street 1:119 N ROBINSON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-4613
Mailing Address - Country:US
Mailing Address - Phone:405-272-0511
Mailing Address - Fax:405-272-0501
Practice Address - Street 1:701 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MCLOUD
Practice Address - State:OK
Practice Address - Zip Code:74851-8500
Practice Address - Country:US
Practice Address - Phone:405-964-2961
Practice Address - Fax:405-964-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH6309314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility