| NPI | 1104036748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA GRAVES Owner 580-592-4953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK OKNH2505) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |