OAK PLACE
NPI 1114002987
Intermediate Care Facility, Intellectual Disabilities in Wetumka, OK

Active since October 27, 2006CLIA 37D1035878 · Waiver
201 E 2ND ST, WETUMKA, OK 74883(405) 452-3271(405) 452-5154 Get Directions Write a Review

NPPES record last updated: January 12, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 12, 2023, Aug 22, 2020 (2 updates tracked since 2020).

About Oak Place NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OAK PLACE (NPI 1114002987) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Wetumka, Oklahoma and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through January 12, 2027 and lists Donna R Simmons, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1114002987
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameOAK PLACE LIVING CENTER, LLC
Location Address201 E 2ND STWetumka, OK 74883-6040
Mailing AddressPo Box 488Weleetka, OK 74880-0488 · (405) 786-2266 · Fax (405) 786-2388
Fax(405) 452-5154
Organization SubpartNo
Authorized OfficialDonna R SimmonsOffice Manager · (405) 380-6671
Enumeration DateOctober 27, 2006
Last NPPES UpdateJanuary 12, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2023
NPI 1114002987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License Licensed in OK · NH3213-3213
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

201 E 2ND ST, Wetumka, OK 74883

Other Names 1

Doing Business AsOak Place

Other Identifiers 1

Medicaid200104640AOK

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
37D1035878
Facility Type
Intermediate Care Facility for Mentally Retarded
Certificate Effective Date
January 13, 2025
Certificate Expiration Date
January 12, 2027
Laboratory Director
CRYSTAL S. FREEMAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Oak Place to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Intermediate Care Facility, Intellectual Disabilities
201 E 2ND ST
WETUMKA, OK 74883

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114002987, enumerated as an "organization" on October 27, 2006.

The provider is located at 201 E 2ND ST WETUMKA, OK 74883 and the phone number is (405) 452-3271.

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.