Provider Demographics
NPI:1912906694
Name:N&R OF WESTHAVEN L L C
Entity Type:Organization
Organization Name:N&R OF WESTHAVEN L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-254-9525
Mailing Address - Street 1:329 TOWNEPARK CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2348
Mailing Address - Country:US
Mailing Address - Phone:502-254-9525
Mailing Address - Fax:502-254-9919
Practice Address - Street 1:1215 S WESTERN RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5151
Practice Address - Country:US
Practice Address - Phone:405-743-1140
Practice Address - Fax:405-743-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNR6006-6006314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100849720AMedicaid
OK375417Medicare Oscar/Certification