# GRAND UNION HEALTHCARE L.L.C,

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Monroe Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013016864
- **Authorized official:** ORRISE MATHESON (ADMINISTRATOR)
- **Authorized official phone:** (918) 253-4500

## Contact information

- **Practice address:** 226 EAST MONROE STREET, JAY, OK 74346-0409
- **Practice address phone:** (918) 253-4500
- **Practice address fax:** (918) 253-6064
- **Mailing address:** PO BOX 409, JAY, OK 74346-0409
- **Mailing address phone:** (918) 253-4500
- **Mailing address fax:** (918) 253-6064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 12/22/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100778240A | — | OK |