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MOORELAND HERITAGE MANOR
NPI 1346385689
Nursing Facility/Intermediate Care Facility in Mooreland, OK

Active since February 21, 2007CLIA 37D0670355 · Waiver
402 SE 6TH ST, MOORELAND, OK 73852(918) 273-3649(918) 273-5652 Get Directions Write a Review

NPPES record last updated: July 20, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mooreland Heritage Manor NPPES

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

MOORELAND HERITAGE MANOR (NPI 1346385689) is a healthcare organization registered as a nursing facility/intermediate care facility in Mooreland, Oklahoma and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Douglas G. Maddux, President, as its authorized official.

NPPES Registry Identity

NPI1346385689
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameLIGHTNING CREEK INVESTMENT GROUP INC
Location Address402 SE 6TH STMooreland, OK 73852-9064
Mailing AddressPo Box 468Nowata, OK 74048-0468 · (918) 273-3649 · Fax (918) 273-5652
Phone(918) 273-3649
Fax(918) 273-5652
Organization SubpartNo
Authorized OfficialDouglas G. MadduxPresident · (918) 273-3649
Enumeration DateFebruary 21, 2007
Last NPPES UpdateJuly 20, 2010
✔ NPI 1346385689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in OK · NH7702-7702
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
402 SE 6TH ST, Mooreland, OK 73852
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Other Names 1

Doing Business AsMooreland Heritage Manor

Other Identifiers 1

Medicaid100776120BOK

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D0670355

Mooreland Heritage Manor · Mooreland, OK
Active · expires Aug 31, 2026
CLIA Number37D0670355
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorConnie Brown
Laboratory Phone(580) 994-5570
Laboratory LocationMooreland Heritage Manor402 Southeast 6th, Mooreland, OK 73852
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT HARRIS
Occupational Therapist
402 SE 6TH ST
MOORELAND, OK 73852
Woodward County (888) 873-4221
HOUSE OF GRACE NURSING FACILITY, L.L.C.
Nursing Facility/Intermediate Care Facility
402 SE 6TH ST
MOORELAND, OK 73852
Woodward County (479) 228-8548
KATELYN JEAN SHEPHERD COTA
Occupational Therapy Assistant
402 SE 6TH ST
MOORELAND, OK 73852
Woodward County (580) 994-5570
JENNIFER CABANISS
Physical Therapy Assistant
402 SE 6TH ST
MOORELAND, OK 73852
Woodward County (888) 873-4221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lightning Creek Investment Group Inc's NPI number?

The NPI number for Lightning Creek Investment Group Inc is 1346385689. It was assigned to this organization in the NPPES registry on February 21, 2007. The provider is doing business as Mooreland Heritage Manor.

Where is Lightning Creek Investment Group Inc located?

Lightning Creek Investment Group Inc is located at 402 SE 6th St, Mooreland, OK 73852. The listed phone number is (918) 273-3649.

What is Lightning Creek Investment Group Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Lightning Creek Investment Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D0670355) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lightning Creek Investment Group Inc was last updated on July 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.