Provider Demographics
NPI:1417248246
Name:SEQUOYAH LIVING CENTERS, INC.
Entity Type:Organization
Organization Name:SEQUOYAH LIVING CENTERS, INC.
Other - Org Name:PLEASANT SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CPA
Authorized Official - Prefix:
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARISH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:918-776-0033
Mailing Address - Street 1:434 STATELINE RD
Mailing Address - Street 2:
Mailing Address - City:COLCORD
Mailing Address - State:OK
Mailing Address - Zip Code:74338-1340
Mailing Address - Country:US
Mailing Address - Phone:918-422-4242
Mailing Address - Fax:918-422-4228
Practice Address - Street 1:434 STATELINE RD
Practice Address - Street 2:
Practice Address - City:COLCORD
Practice Address - State:OK
Practice Address - Zip Code:74338-1340
Practice Address - Country:US
Practice Address - Phone:918-422-4242
Practice Address - Fax:918-422-4228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAL2104-2104310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility