# PARKLAND MANOR LIVING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Parkland Manor Living Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164422416
- **Authorized official:** MISS JULIE JUSTICE (MANAGING MEMBER)
- **Authorized official phone:** (405) 447-3911

## Contact information

- **Practice address:** 200 W PARKLAND NBU 7407, PRAGUE, OK 74864
- **Practice address phone:** (405) 567-2201
- **Practice address fax:** (405) 567-2395
- **Mailing address:** 200 W PARKLAND, PRAGUE, OK 74864
- **Mailing address phone:** (405) 567-2201
- **Mailing address fax:** (405) 567-2395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH4103 | OK | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 08/14/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100770310A | — | OK |