NPI 1366524423

Willow Place Living Center, LLC

Organisation Intellectual Disabilities Intermediate Care Facility Wetumka, OK

Practice location

Address: 622 S Alabama St, Wetumka, OK 74883
Phone: (405) 452-3278
Fax: (405) 452-5154
Mailing address: PO Box 488, Weleetka, OK 74880-0488

Authorised official

Name: Donna R Simmons
Title: Office Manager
Phone: (405) 380-6671

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence NH3203-3203 (OK)

Other Intermediate Care Facility, Intellectual Disabilities providers in Oklahoma →

Registry record

NPI: 1366524423
Entity type: Organization
NPI issued: 19 Oct 2006
Record last updated: 12 Jan 2023

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.