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Organization
WILSHIRE NURSING CENTER LLC
Active
Organization
WILSHIRE NURSING CENTER LLC
Active
Other names
Grace Living Center - Wilshire, The Wilshire Skilled Nursing and Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE DIMOND (MANAGER)
(405) 943-1144
Entity
Organization
Contact information
Practice address
505 E WILSHIRE BLVD, OKLAHOMA CITY, OK 73105-1011
(405) 478-0531
(405) 478-3520
Mailing address
505 E WILSHIRE BLVD, OKLAHOMA CITY, OK 73105-1011
(405) 478-0531
(405) 478-3520
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH5541-5541
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100776920A
—
OK
Enumeration date
09/14/2006
Last updated
09/29/2025
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