Grand Lake Villa Llc

LBN: Grand Lake Villa Llc
Grand Lake Villa Llc is an health care organization with primary practice located at 103 W 13Th St , Grove OK 74344-3224. 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. Grand Lake Villa Llc can be contacted via phone (918) 786-2276, or through Nader, Micheline via phone (918) 786-2276.

Contact Information

Primary practice address
103 W 13Th St Grove OK 74344-3224
Phone: (918) 786-2276
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Nader, Micheline
Phone: (918) 786-2276

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X NH 2102-2102 Oklahoma

Profile Details

NPI number 1740354893
LBN Legal business name Grand Lake Villa Llc
DBA Doing business as
Authorized official Nader, Micheline
Entity Organization
Organization subpart 1 No
Enumeration date Nov 20th, 2006
Last updated Sep 16th, 2011 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1740354893 NPPES
Oklahoma MEDICAID 200059540A

Popular Providers