Organization
LINDSAY MANOR NURSING HOME INC
Active
Other names
Legacy Living Center,
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE PITA (INSURANCE/MEDICARE)
(580) 622-6300
Entity
Organization
Contact information
Practice address
1103 W CHEROKEE ST, LINDSAY, OK 73052-5105
(405) 756-4334
(405) 756-3873
Mailing address
1103 W CHEROKEE, LINDSAY, OK 73052
(405) 756-4334
(405) 756-3873
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
NH25022502
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000375206002
BLUE CROSS BLUE SHIELD OK
OK
05
—
20045030A
—
OK
Enumeration date
10/03/2005
Last updated
05/22/2008
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