| NPI | 1619978301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE DENISE GANTZ Administrator 405-527-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK NH4401-4401) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: OK NH4401-4401) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-08-22 |