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Organization

TIMBERLANE MANOR, LLC

Active
Other names
GRACE LIVING CENTER - EDMOND, The Timbers Skilled Nursing and Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTY DEROIN MBA (DIRECTOR OF REIMBURSEMENT)
(405) 943-1144
Entity
Organization

Contact information

Practice address
2520 SOUTH RANKIN, EDMOND, OK 73013
(405) 341-1433
(405) 562-2128
Mailing address
2520 SOUTH RANKIN, EDMOND, OK 73013
(405) 341-1433
(405) 562-2128

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH5536-5536
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100810270B
OK
Enumeration date
10/03/2006
Last updated
10/14/2025
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