Organization
CONVALESCENT CENTER OF GRADY COUNTY
Active
Other names
GRACE LIVING CENTER - CHICKASHA
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY DEROIN (DIRECTOR OF REIMBURSEMENT)
(405) 943-1144
Entity
Organization
Contact information
Practice address
2300 W IOWA AVE, CHICKASHA, OK 73018-2507
(405) 224-6456
(405) 224-9252
Mailing address
2300 W IOWA AVE, CHICKASHA, OK 73018-2507
(405) 224-6456
(405) 224-9252
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2603-2603
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100685060B
—
OK
Enumeration date
09/14/2006
Last updated
02/05/2026
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