Provider Demographics
NPI:1992207351
Name:HOLIDAY HEIGHTS OPERATIONS LLC
Entity Type:Organization
Organization Name:HOLIDAY HEIGHTS OPERATIONS LLC
Other - Org Name:HOLIDAY HEIGHTS HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:COBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-943-1144
Mailing Address - Street 1:4350 WILL ROGERS PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-1839
Mailing Address - Country:US
Mailing Address - Phone:405-943-1144
Mailing Address - Fax:405-639-2742
Practice Address - Street 1:301 E DALE ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8737
Practice Address - Country:US
Practice Address - Phone:405-321-7932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH1403313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility