Organization
PARKLAND MANOR LIVING CENTER LLC
Active
Other names
Parkland Manor Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JULIE JUSTICE (MANAGING MEMBER)
(405) 447-3911
Entity
Organization
Contact information
Practice address
200 W PARKLAND NBU 7407, PRAGUE, OK 74864
(405) 567-2201
(405) 567-2395
Mailing address
200 W PARKLAND, PRAGUE, OK 74864
(405) 567-2201
(405) 567-2395
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH4103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100770310A
—
OK
Enumeration date
07/28/2005
Last updated
08/14/2014
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