Provider Demographics
NPI:1407225071
Name:WESTVIEW COTTAGES, LLC
Entity type:Organization
Organization Name:WESTVIEW COTTAGES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:PILGRIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-285-8166
Mailing Address - Street 1:PO BOX 990
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-0990
Mailing Address - Country:US
Mailing Address - Phone:405-285-8166
Mailing Address - Fax:405-563-9447
Practice Address - Street 1:1900 W HARRISON AVENUE
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-4053
Practice Address - Country:US
Practice Address - Phone:405-282-0205
Practice Address - Fax:405-282-2592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH4206315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100772950AMedicaid
OK200628930COtherCOTTAGE 3 AND 4
OK200628930DOtherCOTTAGE 3 AND 4
OK201005010AMedicaid
OK201052500AMedicaid