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Organization
LAKESIDE CARE CENTER LLC
Active
Organization
LAKESIDE CARE CENTER LLC
Active
Other names
OAKDALE MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY JEAN EISENMANN ADMINISTRATOR (ADMINISTRATOR)
(918) 545-5908
Entity
Organization
Contact information
Practice address
1025 N ADAMS RD, SAND SPRINGS, OK 74063-8110
(918) 245-5908
(918) 245-3079
Mailing address
1025 N ADAMS RD, SAND SPRINGS, OK 74063-8110
(918) 245-5908
(918) 245-3079
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
20053290A
OK
Other
Enumeration date
08/03/2006
Last updated
04/13/2011
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