Provider Demographics
NPI:1629005137
Name:WILLIAMSON CARE CENTERS,INC.
Entity Type:Organization
Organization Name:WILLIAMSON CARE CENTERS,INC.
Other - Org Name:RAINBOW TERRACE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SHAREHOLDER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-786-2244
Mailing Address - Street 1:300 W 9
Mailing Address - Street 2:
Mailing Address - City:WELEETKA
Mailing Address - State:OK
Mailing Address - Zip Code:74880
Mailing Address - Country:US
Mailing Address - Phone:405-786-2244
Mailing Address - Fax:405-786-2566
Practice Address - Street 1:300 W 9
Practice Address - Street 2:
Practice Address - City:WELEETKA
Practice Address - State:OK
Practice Address - Zip Code:74880
Practice Address - Country:US
Practice Address - Phone:405-786-2244
Practice Address - Fax:405-786-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH 5401-5401313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility