OrganizationChecotah Holdings, Llc(Checotah Manor)Skilled Nursing FacilityNursing & Custodial Care FacilitiesPractice Address321 SE 2nd St, Checotah, OK 74426-4005(918) 473-2251PECOS EnrollmentBased on the most recent information from CMS, provider Checotah Holdings, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:41 AM.Profile DetailsProvider ID1992778278Provider TypeOrganizationFull NameChecotah Holdings, LlcOther NameChecotah ManorSubpartNoEnumeration Date2/8/2006Last Updated8/22/2020Contact InformationPractice LocationPractice Address321 SE 2nd St, Checotah, OK 74426-4005Phone(918) 473-2251FaxUnlisted FaxMailing LocationMailing AddressPO Box 429, Checotah, OK 74426-0429Phone(918) 473-2251FaxUnlisted FaxAuthorized OfficialNameKelsoe, Deborah K (Administrator)Phone(918) 473-5598Provider TaxonomiesCodeDescriptionLicenseCode3140N1450XPrimaryDescriptionSkilled Nursing FacilityNursing & Custodial Care FacilitiesLicense313M00000XOklahomaProvider IdentifiersIDDescriptionIssuerIDNH4602-4602DescriptionMedicaidIssuerUnlistedOklahoma