Provider Demographics
NPI:1538607569
Name:GARDEN MANOR REHAB AND NURSING OF MIDWEST CITY LLC
Entity type:Organization
Organization Name:GARDEN MANOR REHAB AND NURSING OF MIDWEST CITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISCHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-314-3236
Mailing Address - Street 1:945 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1604
Mailing Address - Country:US
Mailing Address - Phone:516-399-3051
Mailing Address - Fax:
Practice Address - Street 1:2900 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4204
Practice Address - Country:US
Practice Address - Phone:405-737-6601
Practice Address - Fax:405-737-4984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
375098Medicare Oscar/Certification