Northside Nursing Home

LBN: D E K Management Llc
Northside Nursing Home is an health care organization with primary practice located at 102 E Line Ave , Sapulpa OK 74066-2858. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. D E K Management Llc can be contacted via phone (918) 224-0833, or through Johnson, Ernest M via phone (918) 224-0833.

Contact Information

Primary practice address
102 E Line Ave Sapulpa OK 74066-2858
Phone: (918) 224-0833
Fax: (918) 227-2405
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Ernest M
Phone: (918) 224-0833

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X NH1902-1902 Oklahoma

Profile Details

NPI number 1629001409
LBN Legal business name D E K Management Llc
DBA Doing business as Northside Nursing Home
Authorized official Johnson, Ernest M
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2006
Last updated Nov 15th, 2012 - about 12 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 1629001409 NPPES
Oklahoma MEDICAID 200044850A

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