OKMULGEE TERRACE, LLC (NPI# 1093816100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093816100 |
| Entity Type | Organization |
| Organization Name | OKMULGEE TERRACE, LLC |
| Practice Address |
210 East Choctaw Street Sallisaw OK 74955-0429 |
| Mailing Address |
Po Box 429 Sallisaw OK 74955-0429 |
| Practice Telephone | 9187754439 |
| Practice Fax Number | 9187759242 |
| Mailing Telephone | 9187754439 |
| Mailing Fax Number | 9187759242 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. KEVIN DOUGLAS MORAN (BUSINESS MANAGEMENT) |
| Authorized Official Telephone | 9187754439 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | NH5607-5607 | OK | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | OKMULGEE TERRACE, LLC | 720 N Miami, Okmulgee, OK 74447 |
| Street Address |
210 EAST CHOCTAW STREET |
| City | SALLISAW |
| State | OK |
| Zip Code | 74955-0429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689775660 | Onhl Home Care Services, LLC | Day Training, Developmentally Disabled Services | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-09-25 |
| 1407942766 | Onhl Home Care Services, LLC | Respite Care | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-05 |
| 1396831657 | Onhl Home Care Services | Homemaker | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-05 |
| 1205922564 | Onhl Home Care Services | Day Training/Habilitation Specialist | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-05 |
| 1114013471 | Onhl Home Care Services | Chore Provider | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-05 |
| 1023104387 | Onhl Home Care Services | Private Vehicle | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-05 |
| 1497841324 | Fairfax Manor LLC | Nursing Facility/Intermediate Care Facility | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-05 |
| 1437242609 | Oak View Health Services | Registered Nurse | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-02 |
| 1346333515 | Oak View Health Services | Day Training, Developmentally Disabled Services | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-02 |
| 1255424420 | Oak View Health Services | Case Management | 210 East Choctaw Street, Sallisaw, OK 74955-0429 | 2006-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057297 | Audrey A. Martin | Technician | 463508 East 1044 Road, Sallisaw, OK 74955 | 2019-11-12 |
| 1013472356 | Christopher Alan Bush | Registered Nurse | 301 Jt Stites, Sallisaw, OK 74955 | 2019-01-31 |
| 1174098941 | Sequoyah County Drug Company Pllc | Pharmacy | 1632 S Kerr Blvd, Sallisaw, OK 74955 | 2018-10-09 |
| 1720570609 | Stephanie Choate | Registered Nurse | 2703 E Phillips Ave, Sallisaw, OK 74955 | 2018-06-05 |
| 1972964666 | Sallisaw Family Medicine, L.L.C. | Family Medicine | 104 South Oak St, Sallisaw, OK 74955 | 2016-03-09 |
| 1407258544 | Mika Goff | Counselor | 301 So. Jt Stites, Sallisaw, OK 74955 | 2014-09-19 |
| 1013348200 | Alton Matlock | Counselor | 2101 Winter Park Drive, Apt/suite, Sallisaw, OK 74955 | 2013-12-12 |
| 1881931509 | Wildhorse Family Practice & Urgent Care | Clinic/Center | 1024 W Cherokee, Sallisaw, OK 74955 | 2013-01-15 |
| 1083966576 | Kayla Plank | Counselor | 204 E Choctaw, Sallisaw, OK 74955 | 2012-10-08 |
| 1427307503 | Brandi Jean Henry | Counselor | 205 S. J.t. Stites, Sallisaw, OK 74955 | 2012-09-05 |
| Find all providers in zip 74955 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (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. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770536013 | Oakridge Home, LLC | Intermediate Care Facility, Mentally Retarded | 210 E Choctaw Ave, Sallisaw, OK 74955-4604 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467959866 | Santa Fe Place LLC | Intermediate Care Facility, Mentally Retarded | 1000 S Santa Fe, Building C, Moore, OK 73160-2469 | 2018-04-11 |
| 1588179600 | Oklahoma Homes for The Developmentally Disabled, LLC | Intermediate Care Facility, Mentally Retarded | 209 E Garber Rd, Garber, OK 73738-1039 | 2017-12-12 |
| 1881055267 | Saint Andre' Bessette | Intermediate Care Facility, Mentally Retarded | 655 West Texas, Okarche, OK 73762-0245 | 2016-03-14 |
| 1598134165 | Guthrie Cottages, LLC | Intermediate Care Facility, Mentally Retarded | 2102 W Warner, Guthrie, OK 73044 | 2015-09-24 |
| 1407225071 | Westview Cottages, Inc | Intermediate Care Facility, Mentally Retarded | 1900 W Harrison Ave, Guthrie, OK 73044-4053 | 2015-09-24 |
| 1407240237 | Fairchild Home and Community Based Services, LLC | Intermediate Care Facility, Mentally Retarded | 205 E Maple, Billings, OK 74630 | 2015-03-18 |
| 1922230341 | Wvl I Lp | Intermediate Care Facility, Mentally Retarded | 2102 West Warner, Guthrie, OK 73044 | 2009-08-18 |
| 1265669667 | Gatesway Foundation Inc | Intermediate Care Facility, Mentally Retarded | 1305 E College St, Broken Arrow, OK 74012-4204 | 2009-06-12 |
| 1457501892 | Gatesway Foundation Inc | Intermediate Care Facility, Mentally Retarded | 1313 E. College, Broken Arrow, OK 74012 | 2008-09-23 |
| 1972762235 | Loosen Center | Intermediate Care Facility, Mentally Retarded | 6th and Texas, Okarche, OK 73762-0245 | 2008-06-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.