| NPI | 1861845125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARVID LADE Manager 918-809-7042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 315P00000X Intermediate Care Facility, Mentally Retarded | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-07-29 |