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Organization

NORTHWEST INCORPORATED

Active
Other names
GRACE LIVING CENTER - NORTHWEST OKC, Fairmont Skilled Nursing and Therapy, Northwest Incorporated, Fairmont
Organization subpart
No

Provider details

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

Contact information

Practice address
3233 NW 10TH ST, OKLAHOMA CITY, OK 73107-5203
(405) 943-8366
(405) 488-0100
Mailing address
3233 NW 10TH ST, OKLAHOMA CITY, OK 73107-5203
(405) 943-8366
(405) 488-0100

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH5511-5511
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100771780A
OK
Enumeration date
09/14/2006
Last updated
02/05/2026
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