# LAKESIDE CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OAKDALE MANOR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619985918
- **Authorized official:** MRS. PATTY JEAN EISENMANN ADMINISTRATOR (ADMINISTRATOR)
- **Authorized official phone:** (918) 545-5908

## Contact information

- **Practice address:** 1025 N ADAMS RD, SAND SPRINGS, OK 74063-8110
- **Practice address phone:** (918) 245-5908
- **Practice address fax:** (918) 245-3079
- **Mailing address:** 1025 N ADAMS RD, SAND SPRINGS, OK 74063-8110
- **Mailing address phone:** (918) 245-5908
- **Mailing address fax:** (918) 245-3079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 20053290A | OK | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 04/13/2011