# KENWOOD MANOR LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENWOOD MANOR LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346314572
- **Legal business name:** KENWOOD MANOR LLC
- **Authorized official:** MICHELINE NADER (OWNER)
- **Authorized official phone:** (918) 786-2276

## Contact information

- **Practice address:** 502 W PINE AVE, ENID, OK 73701-3032
- **Practice address phone:** (580) 233-2722
- **Mailing address:** 502 W PINE AVE, ENID, OK 73701-3032
- **Mailing address phone:** (580) 233-2722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2406-2406 | OK | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 09/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200059530A | — | OK |