# LOCUST GROVE CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Parkhill South Nursing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619964681
- **Authorized official:** MS. SANDRA TAYLOR (VP IN CHARGE OF REIMBURSEMENT)
- **Authorized official phone:** (918) 775-6200

## Contact information

- **Practice address:** 117 WYANDOTTE & ROSS, LOCUST GROVE, OK 74352
- **Practice address phone:** (918) 479-5784
- **Practice address fax:** (918) 479-6254
- **Mailing address:** 201 N ELM ST, SUITE A, SALLISAW, OK 74955-4633
- **Mailing address phone:** (918) 775-6200
- **Mailing address fax:** (918) 775-5643

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2005
- **Last updated:** 08/22/2020