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General NPI Number Information
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NPI Number | 1669469995
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Entity Type | Organization
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Legal Business Name | LINDSAY MANOR NURSING HOME INC
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 1103 W CHEROKEE ST
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City | LINDSAY
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State | OK
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Zip | 73052-5105
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Country | US
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Telephone | 405-756-4334
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Fax | 405-756-3873
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Provider Business Mailing Address
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Address Line | 1103 W CHEROKEE
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City | LINDSAY
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State | OK
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Zip | 73052
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Country | US
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Telephone | 405-756-4334
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Fax | 405-756-3873
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Authorized Official
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Title or Position | INSURANCE/MEDICARE
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Name | JANICE PITA
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Credential |
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Telephone | 580-622-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH25022502
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License Number State | OK
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