Organization
KENWOOD MANOR LLC
Active
Parent organization
KENWOOD MANOR LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENWOOD MANOR LLC
Authorized official
MICHELINE NADER (OWNER)
(918) 786-2276
Entity
Organization
Contact information
Practice address
502 W PINE AVE, ENID, OK 73701-3032
(580) 233-2722
Mailing address
502 W PINE AVE, ENID, OK 73701-3032
(580) 233-2722
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2406-2406
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059530A
—
OK
Enumeration date
11/20/2006
Last updated
09/08/2011
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