Provider Demographics
NPI:1811425606
Name:OAKWOOD RETIREMENT VILLAGE INC
Entity type:Organization
Organization Name:OAKWOOD RETIREMENT VILLAGE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-249-2600
Mailing Address - Street 1:5801 N OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-9344
Mailing Address - Country:US
Mailing Address - Phone:580-249-2600
Mailing Address - Fax:
Practice Address - Street 1:5801 N OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-9344
Practice Address - Country:US
Practice Address - Phone:580-249-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAL2403-2403310400000X
311ZA0620X
OKNH2408-2408314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home