| NPI | 1629001409 |
|---|---|
| Doing Business As | NORTHSIDE NURSING HOME |
| Entity Type | Organization |
| Authorized Contact | ERNEST M JOHNSON Administrator/Managing Member 918-224-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OK NH1902-1902) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-11-15 |