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Organization

LAKESIDE CARE CENTER LLC

Active
Other names
OAKDALE MANOR
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATTY JEAN EISENMANN ADMINISTRATOR (ADMINISTRATOR)
(918) 545-5908
Entity
Organization

Contact information

Practice address
1025 N ADAMS RD, SAND SPRINGS, OK 74063-8110
(918) 245-5908
(918) 245-3079
Mailing address
1025 N ADAMS RD, SAND SPRINGS, OK 74063-8110
(918) 245-5908
(918) 245-3079

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
20053290A
OK

Other

Enumeration date
08/03/2006
Last updated
04/13/2011
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