LAKESIDE CARE CENTER LLC NPI 1619985918

NPI Information

  • NPI: 1619985918
  • Provider Name: LAKESIDE CARE CENTER LLC
  • Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
  • Entity Type: Organization
  • Other Name: OAKDALE MANOR
  • Address: 1025 N ADAMS RD
    SAND SPRINGS, OK
    ZIP 74063
  • Phone: (918) 245-5908

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NPI Details

LAKESIDE CARE CENTER LLC is a nursing facility intermediate care facility in Sand Springs, 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. LAKESIDE CARE CENTER LLC NPI is 1619985918. The provider is registered as an organization entity type.
The provider Other Name Is Oakdale Manor.

The provider's business location address is:

1025 N ADAMS RD
SAND SPRINGS, OK
ZIP 74063-110
Phone: (918) 245-5908
Fax: (918) 245-3079

The provider's authorized official is Patty Jean Eisenmann .
The authorized official title is Administrator and has the following contact phone number (918) 545-5908.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 4/13/2011.

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 Facility20053290AOKLAHOMAYes

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
1375285MEDICARE ID-TYPE UNSPECIFIEDOKLAHOMA

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: 3/30/2025

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