Provider Demographics
NPI:1134223225
Name:BONO NURSING HOME INC
Entity type:Organization
Organization Name:BONO NURSING HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SLYCONISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-652-8797
Mailing Address - Street 1:212 N ANTES
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437
Mailing Address - Country:US
Mailing Address - Phone:918-652-8797
Mailing Address - Fax:918-652-3648
Practice Address - Street 1:212 N ANTES
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437
Practice Address - Country:US
Practice Address - Phone:918-652-8797
Practice Address - Fax:918-652-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH56025602313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility