LEGACY LIVING CENTERS
NPI 1891782298
Nursing Facility/Intermediate Care Facility in Sulphur, OK

Q: What is Forth Worth Manor Inc's NPI number?

The NPI number for Forth Worth Manor Inc is 1891782298. It was assigned to this organization in the NPPES registry on September 30, 2005. The provider is doing business as Legacy Living Centers.

Q: What is Forth Worth Manor Inc's specialty?

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

Active since September 30, 2005

110 W MUSKOGEE AVE, SULPHUR, OK 73086(580) 622-6300(580) 622-8344 Get Directions Write a Review

NPPES record last updated: June 16, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Legacy Living Centers NPPES

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

LEGACY LIVING CENTERS (NPI 1891782298) is a healthcare organization registered as a nursing facility/intermediate care facility in Sulphur, Oklahoma and active in the NPI registry since September 2005. The organization lists Janice Pita, Insurance/medicare, as its authorized official.

NPPES Registry Identity

NPI1891782298

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameFORTH WORTH MANOR INC

Location Address110 W MUSKOGEE AVESulphur, OK 73086-4810

Mailing Address4900 E Berry StFort Worth, TX 76105-4314 · (817) 531-3707 · Fax (817) 536-1648

Phone(580) 622-6300

Fax(580) 622-8344

Organization SubpartNo

Authorized OfficialJanice PitaInsurance/medicare · (580) 622-6300

Enumeration DateSeptember 30, 2005

Last NPPES UpdateJune 16, 2008

✔ NPI 1891782298 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 TX · 113559

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.

110 W MUSKOGEE AVE, Sulphur, OK 73086

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Other Names 1

Doing Business AsLegacy Living Centers

Other Identifiers 3

OtherHH320STX · Blue Cross Blue Shield

Medicare ID-Type Unspecified67-5191TX · Medicare Texas

Medicaid001012189TX

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 Forth Worth Manor Inc's NPI number?

The NPI number for Forth Worth Manor Inc is 1891782298. It was assigned to this organization in the NPPES registry on September 30, 2005. The provider is doing business as Legacy Living Centers.

Where is Forth Worth Manor Inc located?

Forth Worth Manor Inc is located at 110 W Muskogee Ave, Sulphur, OK 73086. The listed phone number is (580) 622-6300.

What is Forth Worth Manor Inc'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 Forth Worth Manor Inc was last updated on June 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.