PHOENIX HEALTHCARE LLC NPI 1356454094

NPI Information

  • NPI: 1356454094
  • Provider Name: PHOENIX HEALTHCARE LLC
  • Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
  • Entity Type: Organization
  • Doing Business As: GROVE NURSING CENTER
  • CLIA Number: 37D0707563
  • Address: 1503 HAR-BER RD
    GROVE, OK
    ZIP 74344
  • Phone: (918) 786-3223

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NPI Details

PHOENIX HEALTHCARE LLC is a nursing facility intermediate care facility in Grove, OK. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. PHOENIX HEALTHCARE LLC NPI is 1356454094. The provider is registered as an organization entity type.
The provider Is Doing Business As Grove Nursing Center.

The provider's business location address is:

1503 HAR-BER RD
GROVE, OK
ZIP 74344-525
Phone: (918) 786-3223
Fax: (918) 786-2664

The provider's authorized official is Les Tallman .
The authorized official title is Administrator and has the following contact phone number (918) 786-3223.

The CLIA number assigned to this NPI record is 37D0707563 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2006 and was last updated on 8/13/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care FacilityNH2106-2106OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200040930FMEDICAIDOKLAHOMA
2375366MEDICARE OSCAR/CERTIFICATIONOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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