NPIMap

Organization Active NPI

Tiaps Rehab Center LLC

  • Skilled Nursing Facility
  • Oklahoma City, OK
National Provider Identifier
1770168627
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TIAPS REHAB CENTER LLC
Practice address
1530 NE Grand Blvd
Oklahoma City, OK 73117-5212
Phone
(405) 681-1155
Fax
(405) 768-1156
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Lance Baller
Title
Manager of Selectis Management, LLC
Phone
(303) 449-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1530 NE Grand Blvd
Oklahoma City, OK 73117-5212

Mailing address

1530 NE Grand Blvd
Oklahoma City, OK 73117-5212
Phone (405) 681-1155

Other names 1

  • Park Place Healthcare and Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210420000220 OK Part A Provider - Skilled Nursing Facility 3375951015 Practice locations: Oklahoma City, OK

Skilled nursing facility certification: CCN 375582

Legal name
TIAPS REHAB CENTER LLC
Doing business as
PARK PLACE HEALTHCARE AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 15, 2021
Last certification
Feb 14, 2025
Beds
106
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Aug 26, 2020 in OK
Enrollment address
1530 NE Grand Blvd
Oklahoma City, OK 73117-5212
Nursing home name
PARK PLACE HEALTHCARE AND REHAB

Care Compare: Nursing home

Medicare Care Compare
Listed as
Park Place Healthcare and RehabCCN 375582
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 15, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10663.9 residents per day on average
Special focus status
SFF
Penalties (3 years)
8Fines totaling $131,280

Processed by Care Compare on Aug 1, 2026.

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
37D2222050Park Place Healthcare & Rehab1530 NE Grand Blvd, Oklahoma City, OK 73117Certificate of waiverApr 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Adam a Desmond Individual Corporate OfficerCeo, Selectis Health Inc Mar 18, 2024
Corporate DirectorBoard of Directors Member Mar 26, 2021
Selectis Management LLC Organization, Greenwood Village, CO LLC, For-profit Operational/Managerial Control Mar 26, 2021 100%
Selectis Health Inc Organization, Greenwood Village, CO Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 26, 2021 100%
Krystal D Eckhart Individual Corporate OfficerVP of Revenue Management Dec 28, 2023
Operational/Managerial ControlVP of Revenue Management Mar 26, 2021

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1770168627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 NE GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731175212",
            "telephone_number": "405-681-1155",
            "fax_number": "405-768-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NE GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731175212",
            "telephone_number": "405-681-1155",
            "fax_number": "405-768-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIAPS REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "BALLER",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "MANAGER OF SELECTIS MANAGEMENT, LLC",
        "authorized_official_telephone_number": "303-449-2100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place Healthcare and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.