# BEACON RIDGE SNF OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beacon Ridge
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417675471
- **Authorized official:** DAVID GANZ (MANAGER)
- **Authorized official phone:** (832) 422-8848

## Contact information

- **Practice address:** 102 E LINE AVE, SAPULPA, OK 74066-2858
- **Practice address phone:** (918) 216-1811
- **Practice address fax:** (918) 514-6709
- **Mailing address:** 102 E LINE AVE, SAPULPA, OK 74066-2858
- **Mailing address phone:** (918) 216-1811
- **Mailing address fax:** (918) 514-6709

## Taxonomy

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

## Other

- **Enumeration date:** 08/16/2022
- **Last updated:** 01/05/2023