# PUTNAM CITY CONVALESCENT CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRACE LIVING CENTER - BETHANY, The Grand at Bethany Skilled Nursing and Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801991534
- **Authorized official:** KRISTY DEROIN (DIRECTOR OF REIMBURSEMENT)
- **Authorized official phone:** (405) 943-1144

## Contact information

- **Practice address:** 7000 NW 32ND ST, BETHANY, OK 73008-3910
- **Practice address phone:** (405) 789-7242
- **Practice address fax:** (405) 495-7562
- **Mailing address:** 7000 NW 32ND ST, BETHANY, OK 73008-3910
- **Mailing address phone:** (405) 789-7242
- **Mailing address fax:** (405) 495-7562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH5518-5518 | OK | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 10/14/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100776760A | — | OK |