# IDABEL HEALTH & REHABILITATION CENTER, LLC

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

## Provider details

- **NPI number:** 1053446542
- **Authorized official:** MR. WILLIAM E. DAVES JR. (MANAGING MEMBER & PRESIDENT)
- **Authorized official phone:** (580) 286-2537

## Contact information

- **Practice address:** HIGHWAY 259 SOUTH, IDABEL, OK 74745
- **Practice address phone:** (580) 286-2537
- **Practice address fax:** (580) 286-5480
- **Mailing address:** PO BOX 299, IDABEL, OK 74745-0299
- **Mailing address phone:** (580) 286-2537
- **Mailing address fax:** (580) 286-5480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH4505-4505 | OK | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 08/22/2020