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Organization
MANGUM NURSING CENTER, LLC
Active
Organization
MANGUM NURSING CENTER, LLC
Active
Other names
GRACE LIVING CENTER - MANGUM, Mangum Skilled Nursing and Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY DEROIN (DIRECTOR OF RCM)
(405) 943-1144
Entity
Organization
Contact information
Practice address
320 CAREY AVE, MANGUM, OK 73554-1624
(580) 782-3346
(580) 782-3126
Mailing address
320 CAREY AVE, MANGUM, OK 73554-1624
(580) 782-3346
(580) 782-3126
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2801-2801
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100776780A
—
OK
Enumeration date
09/14/2006
Last updated
02/05/2026
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