| NPI | 1407923824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSEL WILSIE Managing Member 405-850-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OK NH 5515-5515) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |