| NPI | 1790197747 |
|---|---|
| Doing Business As | NORTHSIDE NURSING HOME |
| Entity Type | Organization |
| Authorized Contact | SCOTT PILGRIM Member 405-285-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OK NH1902) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2020-06-05 |