Provider Demographics
NPI:1437505351
Name:SKYLINE HEIGHTS OPERATING CO LLC IN RECEIVERSHIP
Entity Type:Organization
Organization Name:SKYLINE HEIGHTS OPERATING CO LLC IN RECEIVERSHIP
Other - Org Name:MAPLEWOOD CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RECEIVER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RHOADES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-728-3340
Mailing Address - Street 1:401 S BOSTON AVE
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-4016
Mailing Address - Country:US
Mailing Address - Phone:918-728-3340
Mailing Address - Fax:
Practice Address - Street 1:6202 E 61ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-2119
Practice Address - Country:US
Practice Address - Phone:918-494-8830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility