# WESTERN NURSING HOME LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Western Skilled Nursing and Therapy, GRACE LIVING CENTER - BUFFALO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821182270
- **Authorized official:** KRISTY DEROIN (DIRECTOR OF RCM)
- **Authorized official phone:** (405) 943-1144

## Contact information

- **Practice address:** 111 WALNUT DR, BUFFALO, OK 73834
- **Practice address phone:** (580) 735-2415
- **Practice address fax:** (580) 735-2165
- **Mailing address:** 111 WALNUT DR, BUFFALO, OK 73834-8832
- **Mailing address phone:** (580) 735-2415
- **Mailing address fax:** (580) 735-2165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH3001-3001 | OK | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 02/05/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100810460B | — | OK |