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Organization
EAST SHAWNEE NURSING CENTER L L C
Active
Organization
EAST SHAWNEE NURSING CENTER L L C
Active
Other names
GRACE LIVING CENTER - EAST SHAWNEE, SEQUOYAH POINTE SKILLED NURSING AND THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY DEROIN (DIRECTOR OF REIMBURSEMENT)
(405) 943-1144
Entity
Organization
Contact information
Practice address
614 E CHERRIE ST, TAHLEQUAH, OK 74464-3208
(918) 456-2573
(918) 456-6323
Mailing address
614 E CHERRIE ST, TAHLEQUAH, OK 74464-3208
(918) 456-2573
(918) 456-6323
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1103-1103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772120A
—
OK
Enumeration date
09/14/2006
Last updated
09/30/2025
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