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General NPI Number Information
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NPI Number | 1720799653
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Entity Type | Organization
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Legal Business Name | MONROE MANOR NURSING, LLC
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 226 E MONROE AVE
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City | JAY
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State | OK
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Zip | 74346-2914
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Country | US
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Telephone | 918-919-3276
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Fax | 918-544-6155
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Provider Business Mailing Address
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Address Line | 226 E MONROE AVE
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City | JAY
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State | OK
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Zip | 74346-2914
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Country | US
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Telephone | 918-919-3276
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Fax | 918-544-6155
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Authorized Official
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Title or Position | MEMBER
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Name | ZVI RHINE
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Credential |
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Telephone | 918-919-3276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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