NPI 1578655817

Lakeland Manor INC

Organisation Skilled Nursing Facility Ardmore, OK

Practice location

Address: 604 Lake Murray Dr E, Ardmore, OK 73401-3851
Phone: (580) 223-4501
Fax: (580) 223-5002
Mailing address: PO Box 128, Ardmore, OK 73402-0128

Authorised official

Name: Gary Porter
Title: President Ceo
Phone: (580) 490-9200

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence NH1005-1005 (OK)

Other Skilled Nursing Facility providers in Oklahoma →

Registry record

NPI: 1578655817
Entity type: Organization
NPI issued: 28 Sep 2006
Record last updated: 22 Aug 2020

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.