Grace Living Center - Muskogee

LBN: Azalea Park Manor Llc
Grace Living Center - Muskogee is an health care organization with primary practice located at 4717 W Okmulgee St , Muskogee OK 74401-4657. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Azalea Park Manor Llc can be contacted via phone (918) 683-2914, or through Dimond, Mike via phone (405) 943-1144.

Contact Information

Primary practice address
4717 W Okmulgee St Muskogee OK 74401-4657
Phone: (918) 683-2914
Fax: (918) 683-3167
Website:
Map and Directions
Authorized official contact:
Name: Dimond, Mike
Phone: (405) 943-1144

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X NH5106-5106 Oklahoma

Profile Details

NPI number 1699870329
LBN Legal business name Azalea Park Manor Llc
DBA Doing business as Grace Living Center - Muskogee
Authorized official Dimond, Mike
Entity Organization
Organization subpart 1 No
Enumeration date Sep 14th, 2006
Last updated Mar 23rd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699870329 NPPES
Oklahoma MEDICAID 100772250A

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