OKLAHOMA HOMES FOR THE DEVELOPMENTALLY DISABLED, LLC (NPI# 1588179600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588179600 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA HOMES FOR THE DEVELOPMENTALLY DISABLED, LLC |
| Other Organization Name | MATTOX HALL |
| Practice Address |
209 E Garber Rd Garber OK 73738-1039 |
| Mailing Address |
Po Box 366 Billings OK 74630-0366 |
| Practice Telephone | 5808632200 |
| Practice Fax Number | 5808632206 |
| Mailing Telephone | 5807253400 |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |
| Authorized Official Name | MR. BARRY LEWALLEN (ADMINISTRATOR) |
| Authorized Official Telephone | 5807253400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | NH2403-2403 | OK | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Mattox Hall | Doing Business As Name - Organization |
| Street Address |
209 E GARBER RD |
| City | GARBER |
| State | OK |
| Zip Code | 73738-1039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700889839 | Garber Emergency Medical Service (gems) | Ambulance | 19907 E Phillips Rd, Garber, OK 73738-0497 | 2005-05-23 |
| 1528060019 | Integris Bass Baptist Health Center | Family Medicine | 316 Main St, Po Bx 659, Garber, OK 73738-0659 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578982252 | Everlasting Home Healthcare, L.L.C. | Home Health | 37029 Iowa Ave, Garber, IA 52048-8048 | 2014-04-10 |
| 1528060019 | Integris Bass Baptist Health Center | Family Medicine | 316 Main St, Po Bx 659, Garber, OK 73738-0659 | 2005-08-15 |
| 1700889839 | Garber Emergency Medical Service (gems) | Ambulance | 19907 E Phillips Rd, Garber, OK 73738-0497 | 2005-05-23 |
| 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 |
|---|---|---|---|---|
| 1467959866 | Santa Fe Place LLC | Intermediate Care Facility, Mentally Retarded | 1000 S Santa Fe, Building C, Moore, OK 73160-2469 | 2018-04-11 |
| 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 |
| 1134302573 | Santa Fe Cheyenne House | Intermediate Care Facility, Mentally Retarded | 1000b S Santa Fe Ave, Moore, OK 73160-2469 | 2007-12-07 |
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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.