HOMESTEAD OF WEATHERFORD OPERATIONS LLC
NPI 1114590247
Assisted Living Facility in Weatherford, OK

Active since July 16, 2021CLIA 37D2196280 · Waiver
3601 E MAIN ST, WEATHERFORD, OK 73096(580) 774-2955 Get Directions Write a Review

NPPES record last updated: July 16, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Assisted Living Facility
  • CLIA Number: 37D2196280
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 10-14-2026

About HOMESTEAD OF WEATHERFORD OPERATIONS LLC

This page provides the complete NPI Profile along with additional information for Homestead Of Weatherford Operations Llc, a provider established in Weatherford, Oklahoma operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1114590247 assigned on July 2021. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mr. Michael D Tryon Cpa (Cfo)

NPI
1114590247 Verify this NPI
Provider Name
HOMESTEAD OF WEATHERFORD OPERATIONS LLC
Entity Type
Organization
Location Address
3601 E MAIN ST WEATHERFORD, OK 73096
Location Phone
(580) 774-2955
Mailing Address
3024 SW WANAMAKER RD STE 300 TOPEKA, KS 66614
Mailing Phone
(785) 272-1535
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-16-2021
Last Update Date
07-16-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. MICHAEL D TRYON CPA

Authorized Official Title
CFO
Authorized Official Phone
(785) 272-1535

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
37D2196280
Facility Type
Assisted Living Facility
Certificate Effective Date
October 15, 2024
Certificate Expiration Date
October 14, 2026
Laboratory Director
ASHLEY M. LAGRANGE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Homestead Of Weatherford Operations Llc 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.

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Other Providers at the Same Location


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

Point of Service
3601 E MAIN ST
WEATHERFORD, OK 73096

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114590247, enumerated as an "organization" on July 16, 2021.

The provider is located at 3601 E MAIN ST WEATHERFORD, OK 73096 and the phone number is (580) 774-2955.

Assisted Living Facility with taxonomy code 310400000X.