Organization Active NPI

House of Grace Nursing Facility, L.L.C.

  • Nursing Facility/Intermediate Care Facility
  • Mooreland, OK
National Provider Identifier
1215749254
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
HOUSE OF GRACE NURSING FACILITY, L.L.C.
Practice address
402 SE 6TH St
Mooreland, OK 73852-9064
Phone
(479) 228-8548
NPI assigned
Jan 27, 2025
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rindi Citty
Title
Manager
Phone
(479) 228-8548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NU Primary

Addresses

Primary practice location

402 SE 6TH St
Mooreland, OK 73852-9064

Mailing address

402 SE 6TH St
Mooreland, OK 73852-9064
Phone (479) 228-8548

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2320150House of Grace Nursing Facility LLC402 SE 6TH St, Mooreland, OK 73852Certificate of waiverMar 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1215749254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 SE 6TH ST",
            "city": "MOORELAND",
            "state": "OK",
            "postal_code": "738529064",
            "telephone_number": "479-228-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SE 6TH ST",
            "city": "MOORELAND",
            "state": "OK",
            "postal_code": "738529064",
            "telephone_number": "479-228-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF GRACE NURSING FACILITY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-26",
        "status": "A",
        "authorized_official_last_name": "CITTY",
        "authorized_official_first_name": "RINDI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-228-8548"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooreland, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.