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CRESTRIDGE PLACE
NPI 1639262702
Nursing Facility/Intermediate Care Facility in Watonga, OK

Active since October 02, 2006
816 N CLARENCE NASH BLVD, WATONGA, OK 73772(580) 623-7249(580) 623-7245 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Crestridge Place NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRESTRIDGE PLACE (NPI 1639262702) is a healthcare organization registered as a nursing facility/intermediate care facility in Watonga, Oklahoma and active in the NPI registry since October 2006. The organization lists James Sims, Owner, as its authorized official.

NPPES Registry Identity

NPI1639262702
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameCRESTRIDGE LLC
Location Address816 N CLARENCE NASH BLVDWatonga, OK 73772-2024
Mailing AddressPo Box 727Okeene, OK 73763-0727 · (580) 822-4441 · Fax (580) 822-4431
Phone(580) 623-7249
Fax(580) 623-7245
Organization SubpartNo
Authorized OfficialJames SimsOwner · (580) 822-4441
Enumeration DateOctober 2, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1639262702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in OK · NH0603-0603
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.
816 N CLARENCE NASH BLVD, Watonga, OK 73772
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Other Names 1

Doing Business AsCrestridge Place

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crestridge LLC's NPI number?

The NPI number for Crestridge LLC is 1639262702. It was assigned to this organization in the NPPES registry on October 2, 2006. The provider is doing business as Crestridge Place.

Where is Crestridge LLC located?

Crestridge LLC is located at 816 N Clarence Nash Blvd, Watonga, OK 73772. The listed phone number is (580) 623-7249.

What is Crestridge LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for Crestridge LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.