Organization · Type 2 NPI
Okmulgee Terrace, LLC
Intellectual Disabilities Intermediate Care Facility · Sallisaw, OK
NPI number
1093816100
Active
Practice location
210 East Choctaw Street
Sallisaw, OK 74955-0429
Fax (918) 775-9242
Mailing address
PO Box 429
Sallisaw, OK 74955-0429
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | NH5607-5607 (OK) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
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About NPI 1093816100
Okmulgee Terrace, LLC's National Provider Identifier is 1093816100, issued on Sep 25, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Sallisaw, OK. The record was last updated on Aug 22, 2020.