Organization
GRANDWOOD ASSISTED LIVING, LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY YOUNT (OWNER)
(918) 787-2011
Entity
Organization
Contact information
Practice address
2001 SUNRISE BLVD, GROVE, OK 74344-3617
(918) 787-2011
(918) 787-2077
Mailing address
2001 SUNRISE BLVD, GROVE, OK 74344-3617
(918) 787-2011
(918) 787-2077
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL2103-2103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0451
OKLAHOMA STATE
OK
Enumeration date
04/13/2012
Last updated
04/13/2012
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