- Enrollment id
- O20200617000790
- Enrollment state
- OK
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1467790402
- Multiple npi flag
- N
- Ccn
- 375449
- Associate id
- 3577985704
- Organization name
- LANE NURSING & VENTILATOR CARE, LLC
- Doing business as name
- INOLA HEALTH & REHABILITATION
- Incorporation date
- 2012-06-19
- Incorporation state
- OK
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LANE NURSING & VENTILATOR CARE
- Address line 1
- 400 N BROADWAY
- City
- INOLA
- State
- OK
- Zip code
- 740369424