NPI 1497841324

Fairfax Manor LLC

Organisation Nursing Facility/Intermediate Care Facility Sallisaw, OK

Practice location

Address: 210 East Choctaw Street, Sallisaw, OK 74955-0429
Phone: (918) 775-4439
Fax: (918) 775-9242
Mailing address: PO Box 429, Sallisaw, OK 74955-0429

Authorised official

Name: Justin McGrew
Title: Business Management
Phone: (918) 775-4439

Registered specialties

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence NH5702-5702 (OK)

Other Nursing Facility/Intermediate Care Facility providers in Oklahoma →

Registry record

NPI: 1497841324
Entity type: Organization
NPI issued: 5 Oct 2006
Record last updated: 24 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.