WILLOW PLACE
NPI 1366524423
Intermediate Care Facility, Intellectual Disabilities in Wetumka, OK

Q: What is Willow Place Living Center, LLC's NPI number?

The NPI number for Willow Place Living Center, LLC is 1366524423. It was assigned to this organization in the NPPES registry on October 19, 2006. The provider is doing business as Willow Place.

Q: What is Willow Place Living Center, LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since October 19, 2006

622 S ALABAMA ST, WETUMKA, OK 74883(405) 452-3278(405) 452-5154 Get Directions Write a Review

NPPES record last updated: January 12, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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

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About Willow Place NPPES

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

WILLOW PLACE (NPI 1366524423) 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 lists Donna R Simmons, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1366524423

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameWILLOW PLACE LIVING CENTER, LLC

Location Address622 S ALABAMA STWetumka, OK 74883

Mailing AddressPo Box 488Weleetka, OK 74880-0488 · (405) 786-2266 · Fax (405) 786-2388

Phone(405) 452-3278

Fax(405) 452-5154

Organization SubpartNo

Authorized OfficialDonna R SimmonsOffice Manager · (405) 380-6671

Enumeration DateOctober 19, 2006

Last NPPES UpdateJanuary 12, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 12, 2023

✔ NPI 1366524423 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 · NH3203-3203

Definition

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

622 S ALABAMA ST, Wetumka, OK 74883

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Other Names 1

Doing Business AsWillow Place

Other Identifiers 1

Medicaid200106050AOK

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 Willow Place Living Center, LLC's NPI number?

The NPI number for Willow Place Living Center, LLC is 1366524423. It was assigned to this organization in the NPPES registry on October 19, 2006. The provider is doing business as Willow Place.

Where is Willow Place Living Center, LLC located?

Willow Place Living Center, LLC is located at 622 S Alabama St, Wetumka, OK 74883. The listed phone number is (405) 452-3278.

What is Willow Place Living Center, LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Willow Place Living Center, LLC was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.