Provider Demographics
NPI:1043798069
Name:SA OPERATIONS LLC
Entity Type:Organization
Organization Name:SA OPERATIONS LLC
Other - Org Name:ST. ANN'S HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROIN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:405-943-1144
Mailing Address - Street 1:9400 SAINT ANN DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6400
Mailing Address - Country:US
Mailing Address - Phone:405-728-7888
Mailing Address - Fax:405-728-1302
Practice Address - Street 1:9400 SAINT ANN DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6400
Practice Address - Country:US
Practice Address - Phone:405-728-7888
Practice Address - Fax:405-728-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH5529314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375561OtherMEDICARE