Organization · Type 2 NPI

Eidetik of Weleetka

Intellectual Disabilities Intermediate Care Facility · Henryetta, OK

NPI number 1992925598 Active

Practice location

1201 W Trudgeon St
Henryetta, OK 74437-4007

Call (918) 650-9393 Map

Fax (918) 650-0270

Mailing address

P.o. Box 525
Morganfield, KY 42437

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	200001070A (OK)

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

17 other providers at this address

Other intellectual disabilities intermediate care facility providers in Henryetta

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NPI record

NPI: 1992925598
Entity type: Organization (Type 2)
Issued: Apr 26, 2007
Last updated: Feb 22, 2023
Status: Active
Subpart: Yes of Eidetik of Weleetka, LLC

Other names

<unavail>
The Reach Corporation Oneida Place · doing business as

Authorized official

Laila Beaven
Registered Agent
(270) 389-1919

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1992925598

Eidetik of Weleetka's National Provider Identifier is 1992925598, issued on Apr 26, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Henryetta, OK. The record was last updated on Feb 22, 2023.