NPI 1215019195

Cypress Place Living Center, LLC

Organisation Intellectual Disabilities Intermediate Care Facility Wetumka, OK

Practice location

Address: 204 E 1st St, Wetumka, OK 74883-6041
Phone: (405) 452-3271
Fax: (405) 452-5154
Mailing address: PO Box 488, Weleetka, OK 74880-0488

Authorised official

Name: Donna R Simmons
Title: Office Manager
Phone: (405) 786-2266

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence NH3212-3212 (OK)

Other Intermediate Care Facility, Intellectual Disabilities providers in Oklahoma →

Registry record

NPI: 1215019195
Entity type: Organization
NPI issued: 19 Oct 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.