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Organization
PARKLAND MANOR LIVING CENTER LLC
Active
Organization
PARKLAND MANOR LIVING CENTER LLC
Active
Other names
Parkland Manor Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JULIE JUSTICE (MANAGING MEMBER)
(405) 447-3911
Entity
Organization
Contact information
Practice address
200 W PARKLAND NBU 7407, PRAGUE, OK 74864
(405) 567-2201
(405) 567-2395
Mailing address
200 W PARKLAND, PRAGUE, OK 74864
(405) 567-2201
(405) 567-2395
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH4103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100770310A
—
OK
Enumeration date
07/28/2005
Last updated
08/14/2014
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