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Organization
WESTERN NURSING HOME LLC
Active
Organization
WESTERN NURSING HOME LLC
Active
Other names
Western Skilled Nursing and Therapy, GRACE LIVING CENTER - BUFFALO
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY DEROIN (DIRECTOR OF RCM)
(405) 943-1144
Entity
Organization
Contact information
Practice address
111 WALNUT DR, BUFFALO, OK 73834
(580) 735-2415
(580) 735-2165
Mailing address
111 WALNUT DR, BUFFALO, OK 73834-8832
(580) 735-2415
(580) 735-2165
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH3001-3001
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100810460B
—
OK
Enumeration date
10/02/2006
Last updated
02/05/2026
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