# GRACEWOOD HEALTH & REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRACEWOOD HEALTH & REHAB
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770956625
- **Authorized official:** BRADFORD MONTGOMERY (MEMBER)
- **Authorized official phone:** (479) 715-6759

## Contact information

- **Practice address:** 6201 E 36TH ST, TULSA, OK 74135-5810
- **Practice address phone:** (918) 622-3430
- **Practice address fax:** (918) 622-0626
- **Mailing address:** 9 PROFESSIONAL DR, BELLA VISTA, AR 72715-8462
- **Mailing address phone:** (479) 715-6759
- **Mailing address fax:** (479) 715-6922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH7229 | OK | Yes |

## Other

- **Enumeration date:** 10/31/2015
- **Last updated:** 06/07/2024