NPIMap

Organization Active NPI

Reliant Living Centers of Oklahoma, Inc

Doing business as Mansfield Manor

  • Nursing Facility/Intermediate Care Facility
  • Del City, OK
National Provider Identifier
1558408609
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
NH5557 Issued in OK
Legal business name
RELIANT LIVING CENTERS OF OKLAHOMA, INC
Doing business as
Mansfield Manor
Practice address
3317 SE 18TH St
Del City, OK 73115-1413
Phone
(405) 677-2421
Fax
(405) 677-2497
NPI assigned
Jan 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bill J Florence, ADMINISTRATOR
Title
Administrator
Phone
(405) 677-2421

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NH5557 OK Primary

Addresses

Primary practice location

3317 SE 18TH St
Del City, OK 73115-1413

Mailing address

3317 SE 18TH St
Del City, OK 73115-1413
Phone (405) 677-2421

Other names 1

  • Mansfield Manor Doing business as

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
37D0893747Mansfield Manor3317 SE 18TH, Del City, OK 73115Certificate of waiverOct 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
Bryant Place5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558408609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 SE 18TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731151413",
            "telephone_number": "405-677-2421",
            "fax_number": "405-677-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 SE 18TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731151413",
            "telephone_number": "405-677-2421",
            "fax_number": "405-677-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT LIVING CENTERS OF OKLAHOMA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLORENCE",
        "authorized_official_first_name": "BILL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "405-677-2421",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH5557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mansfield Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Del City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.