Provider Demographics
NPI:1376261339
Name:LINWOOD VILLAGE OPERATIONS LLC
Entity Type:Organization
Organization Name:LINWOOD VILLAGE OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-422-8848
Mailing Address - Street 1:530 S LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-4644
Mailing Address - Country:US
Mailing Address - Phone:918-225-2220
Mailing Address - Fax:918-225-3480
Practice Address - Street 1:530 S LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-4644
Practice Address - Country:US
Practice Address - Phone:918-225-2220
Practice Address - Fax:918-225-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility