CREEK PLACE (EIDETIK OF WELEETKA, LLC) NPI 1003036609

Intermediate Care Facility, Mentally Retarded in Henryetta, OK

NPI 1003036609 Organization Intermediate Care Facility, Mentally Ret...

About CREEK PLACE (EIDETIK OF WELEETKA, LLC)

Creek Place (eidetik Of Weleetka, Llc) is a provider established in Henryetta, Oklahoma specializing in intermediate care facility, mentally retarded. The NPI number of Creek Place (eidetik Of Weleetka, Llc) is 1003036609 and was assigned on April 2007. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Creek Place. The authorized official of this NPI record is Roy Bentley (Executive Director)

NPI

1003036609

Provider NameCREEK PLACE (EIDETIK OF WELEETKA, LLC)
Provider Location Address1201 W TRUDGEON ST HENRYETTA, OK 74437
Provider Mailing Address1201 W TRUDGEON ST HENRYETTA, OK 74437
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameCREEK PLACE
Other Name TypeDoing Business As (3)
Enumeration Date04-26-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code315P00000X
ClassificationIntermediate Care Facility, Mentally Retarded
TypeNursing & Custodial Care Facilities
License StateOK
Taxonomy Description(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.

Business Address

CREEK PLACE
1201 W TRUDGEON ST
HENRYETTA, OK
ZIP 74437
Phone: (918) 650-9393
Fax: (918) 650-0270

Get Directions


Mailing Address

CREEK PLACE
1201 W TRUDGEON ST
HENRYETTA, OK
ZIP 74437
Phone: (918) 650-9393
Fax: (918) 650-0270



Authorized Official

Authorized Official Name ROY BENTLEY
Authorized Official TitleEXECUTIVE DIRECTOR
Authorized Official Phone(918) 650-9393

Other Providers at the same location


The following 18 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1407972045EIDETIK OF WELEEKTA, L.L.C.
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1992925598EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1801016407EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1710107313EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1629298229EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1538389135EIDETIK OF WELEETKA. LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1518187111EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1427278027EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1336369933EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1245450840EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1568682169EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1386864981EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1194945790EIDETIK OF WELEETKA LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1912127515EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1821218421EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1730309337EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1649490244EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393
1952521551EIDETIK OF WELEETKA, LLC
Organization
Intermediate Care Facility, Mentally Retarded1201 W TRUDGEON ST
HENRYETTA, OK 74437
(918) 650-9393

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.