OrganizationActive
Eastwood Manor, LLC
NPI 1417058470 · Nursing Facility/Intermediate Care Facility · Commerce, OK
Provider details
- NPI number
- 1417058470
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Moran, Business Management(918) 775-4439
- License
- NH5802-5802 (OK)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
519 N Mickey Mantle Blvd
Commerce, OK 74339-1127
Phone: (918) 675-4455
Fax: (918) 675-5472
Street-level locationGet directions
Mailing address
Po Box 429
Sallisaw, OK 74955-0429
Registry dates
- Enumerated
- 2006-09-25
- Last updated
- 2008-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.