# STILLWATER NURSING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRACE LIVING CENTER - STILLWATER, Stillwater Creek Skilled Nursing and Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023113826
- **Authorized official:** KRISTY DEROIN (DIRECTOR OF RCM)
- **Authorized official phone:** (405) 943-1144

## Contact information

- **Practice address:** 1215 W 10TH AVE, STILLWATER, OK 74074-5420
- **Practice address phone:** (405) 372-1000
- **Practice address fax:** (405) 377-7051
- **Mailing address:** 1215 W 10TH AVE, STILLWATER, OK 74074-5420
- **Mailing address phone:** (405) 372-1000
- **Mailing address fax:** (405) 377-7051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH6004-6004 | OK | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 02/05/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100810490B | — | OK |