Provider Demographics
NPI:1033310370
Name:NARULAS HEALTHCARE LLC
Entity Type:Organization
Organization Name:NARULAS HEALTHCARE LLC
Other - Org Name:MUSTANG MANOR ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP BUSINESS MGR
Authorized Official - Prefix:
Authorized Official - First Name:S
Authorized Official - Middle Name:WENDY
Authorized Official - Last Name:MCENTIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-737-0881
Mailing Address - Street 1:1380 S DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5215
Mailing Address - Country:US
Mailing Address - Phone:405-737-0881
Mailing Address - Fax:405-737-0899
Practice Address - Street 1:1017 W HIGHWAY 152
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064
Practice Address - Country:US
Practice Address - Phone:405-376-5600
Practice Address - Fax:405-376-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAL0902-0902310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility