NPI 1740354893

Grand Lake Villa LLC

Organisation Skilled Nursing Facility Grove, OK

Practice location

Address: 103 W 13th St, Grove, OK 74344-3224
Phone: (918) 786-2276

Authorised official

Name: Micheline Nader
Title: Owner
Phone: (918) 786-2276

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence NH 2102-2102 (OK)

Other Skilled Nursing Facility providers in Oklahoma →

Registry record

NPI: 1740354893
Entity type: Organization
NPI issued: 20 Nov 2006
Record last updated: 16 Sep 2011

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.