Provider Demographics
NPI:1346247285
Name:QUINTON ELDER CARE HOME, INC.
Entity Type:Organization
Organization Name:QUINTON ELDER CARE HOME, INC.
Other - Org Name:QUINTON MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUYKENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-649-6170
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:OK
Mailing Address - Zip Code:74561-0359
Mailing Address - Country:US
Mailing Address - Phone:918-469-2600
Mailing Address - Fax:918-469-2208
Practice Address - Street 1:1209 WEST MAIN
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:OK
Practice Address - Zip Code:74561-0359
Practice Address - Country:US
Practice Address - Phone:918-469-2600
Practice Address - Fax:918-469-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility