Eidetik Of Weleetka, Llc in Henryetta - Intermediate Care Facility, Intellectual Disabilities
Eidetik Of Weleetka, Llc - NPI 1710107313
Eidetik Of Weleetka, Llc is a Intermediate Care Facility, Intellectual Disabilities in Henryetta, Oklahoma. Eidetik Of Weleetka, Llc practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Eidetik Of Weleetka, Llc is 1710107313. The last update date is 2022-12-21.
Eidetik Of Weleetka, Llc's current location address is 1201 W Trudgeon St, Henryetta, Oklahoma. You can contact this provider via phone number 9186509393 and fax number 9186500270. The mailing address for Eidetik Of Weleetka, Llc is 1201 W Trudgeon St, Henryetta, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eidetik Of Weleetka, Llc |
|---|---|
| Address | 1201 W Trudgeon St, Henryetta, Oklahoma |
| Phone Number | 9186509393 |
| Fax Number | 9186500270 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | REGISTERED |
|---|---|
| Authorized Official Name | Beaven Laila |
| Telephone Number | 2703891919 |
NPI Number Detail
| NPI Number | 1710107313 |
|---|---|
| Provider Enumeration Date | 2007-04-26 |
| Last Updated Date | 2022-12-21 |
Provider Mailing Address Detail
| Address | 1201 W Trudgeon St |
|---|---|
| City | Henryetta |
| State | Oklahoma (OK) |
| Post Code | 744374007 |
| Phone Number | 9186509393 |
| Fax Number | 9186500270 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 200001110B |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200001110B | OK | -- |
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What is the Eidetik Of Weleetka, Llc's 1710107313?
The Eidetik Of Weleetka, Llc's NPI (National Provider Identifier) Number is 1710107313. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Eidetik Of Weleetka, Llc located?
The Eidetik Of Weleetka, Llc is located at 1201 W Trudgeon St, Henryetta, OK 744374007.
What is the Eidetik Of Weleetka, Llc's area of specialization and corresponding taxonomy classification?
The Eidetik Of Weleetka, Llc's specialty field is Intermediate Care Facility, Intellectual Disabilities, and it falls under the taxonomy code 315P00000X, which categorizes healthcare providers based on their specialties.
When did the Eidetik Of Weleetka, Llc receive its 1710107313?
The Eidetik Of Weleetka, Llc was issued its 1710107313 on 2007-04-26, which is the date when the organization was assigned this unique identifier.
As of what date were the Eidetik Of Weleetka, Llc's details last updated?
The information pertaining to the Eidetik Of Weleetka, Llc, including its address, specialty, and other details, was most recently updated on 2022-12-21.