Provider Demographics
NPI:1265428866
Name:LINDSAY MANOR
Entity type:Organization
Organization Name:LINDSAY MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-756-4334
Mailing Address - Street 1:1103 W CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:OK
Mailing Address - Zip Code:73052-5105
Mailing Address - Country:US
Mailing Address - Phone:405-756-4334
Mailing Address - Fax:405-756-3873
Practice Address - Street 1:1103 W CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:OK
Practice Address - Zip Code:73052-5105
Practice Address - Country:US
Practice Address - Phone:405-756-4334
Practice Address - Fax:405-756-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375206Medicare ID - Type Unspecified