Healthcare Provider Details

I. General information

NPI: 1437697463
Provider Name (Legal Business Name): GARDEN MANOR REHAB AND NURSING OF TULSA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 S MEMORIAL DR
TULSA OK
74129-2617
US

IV. Provider business mailing address

2425 S MEMORIAL DR
TULSA OK
74129-2617
US

V. Phone/Fax

Practice location:
  • Phone: 918-628-0932
  • Fax: 918-622-2060
Mailing address:
  • Phone: 918-628-0932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DAVID FLEISCHMANN
Title or Position: CONTROLLER
Credential:
Phone: 516-314-3236