Organization · Type 2 NPI

Willow Place Living Center, LLC

Intellectual Disabilities Intermediate Care Facility · Wetumka, OK

NPI number 1366524423 Active

Practice location

622 S Alabama St
Wetumka, OK 74883

Call (405) 452-3278 Map

Fax (405) 452-5154

Mailing address

PO Box 488
Weleetka, OK 74880-0488

Specialties and licenses

TaxonomyCodeLicense
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XNH3203-3203 (OK)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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About NPI 1366524423

Willow Place Living Center, LLC's National Provider Identifier is 1366524423, issued on Oct 19, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Wetumka, OK. The record was last updated on Jan 12, 2023.