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Forth Worth Manor Inc
Nursing Facility/Intermediate Care Facility in Sulphur, Oklahoma
NPI 1891782298

Forth Worth Manor Inc is a Nursing Facility/Intermediate Care Facility based in Fort Worth, OK. Forth Worth Manor Inc practices in Sulphur, OK. The NPI Number for Forth Worth Manor Inc is 1891782298 and holds a License No. 113559 (Oklahoma).

The current practice location address for Forth Worth Manor Inc is 110 W Muskogee Ave, Sulphur, OK and can be reached out via phone at 580-622-6300 and via fax at 580-622-8344.

Location: 110 W Muskogee Ave, Sulphur, OK, 76105-4314
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1891782298
Provider Name
Forth Worth Manor Inc
Credential
Provider Entity Type
Organization
Address
110 W Muskogee Ave, Sulphur, OK, 76105-4314
Phone Number
580-622-6300
Fax Number
580-622-8344
Provider Enumeration Date
09/30/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HH320S 01 TX BLUE CROSS BLUE SHIELD
001012189 05 TX
institution
Provider Business Practice Location Address Details
Address
110 W Muskogee Ave
City
Sulphur
State
Oklahoma
Zip
73086-4810
Phone Number
580-622-6300
Fax Number
580-622-8344
person
Provider Business Mailing Address Details
Address
110 W Muskogee Ave
City
Sulphur
State
Oklahoma
Zip
73086-4810
Phone Number
580-622-6300
Fax Number
580-622-8344
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
113559 (Texas)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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