Organization
AZALEA PARK MANOR LLC
Active
Other names
The Springs Skilled Nursing and Therapy, GRACE LIVING CENTER - MUSKOGEE
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY DEROIN (DIRECTOR OF RCM)
(405) 943-1144
Entity
Organization
Contact information
Practice address
4717 W OKMULGEE ST, MUSKOGEE, OK 74401-4657
(918) 683-2914
(918) 683-3167
Mailing address
5800 W OKMULGEE ST, MUSKOGEE, OK 74401-4552
(918) 683-2914
(918) 683-3167
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH5106-5106
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772250A
—
OK
Enumeration date
09/14/2006
Last updated
02/05/2026
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