Healthcare Provider Details

I. General information

NPI: 1619487188
Provider Name (Legal Business Name): LINDSAY NURSING & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 W CHEROKEE ST
LINDSAY OK
73052-5105
US

IV. Provider business mailing address

9 PROFESSIONAL DR
BELLA VISTA AR
72715-8462
US

V. Phone/Fax

Practice location:
  • Phone: 405-756-4334
  • Fax: 405-756-3873
Mailing address:
  • Phone: 479-715-6759
  • Fax: 479-715-6922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH2502
License Number StateOK

VIII. Authorized Official

Name: BRADFORD MONTGOMERY
Title or Position: MANAGING MEMBER
Credential:
Phone: 479-715-6759