ANGELWOOD ASSISTED LIVING & MEMORY CARE, LLC (NPI# 1770788630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770788630 |
| Entity Type | Organization |
| Organization Name | ANGELWOOD ASSISTED LIVING & MEMORY CARE, LLC |
| Practice Address |
3200 Hayes Ave Clinton OK 73601-3514 |
| Mailing Address |
78 Centennial Loop Eugene OR 97401-7900 |
| Practice Telephone | 5803230990 |
| Practice Fax Number | 5803230999 |
| Mailing Telephone | 5417473373 |
| Mailing Fax Number | 5417470673 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | MR. JOHN HOLTZ (CONTROLLER) |
| Authorized Official Telephone | 5417473373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Street Address |
3200 HAYES AVE |
| City | CLINTON |
| State | OK |
| Zip Code | 73601-3514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790308989 | Wc-angelwood Ops, LLC | Assisted Living Facility | 3200 Hayes Ave, Clinton, OK 73601-3514 | 2020-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225514458 | April Walker | Pharmacist | 100 N. 30th, Clinton, OK 73601 | 2018-07-11 |
| 1477045995 | Dynamic Psychological & Mediation Services | Counselor | 104 S 7th St, Clinton, OK 73601 | 2018-05-31 |
| 1619490851 | Kristyn Wagner | Social Worker | 90 N 31st Street, Clinton, OK 73601 | 2017-07-19 |
| 1124478193 | Lindsay Dlugonski | Nurse Practitioner | 545 S. 30th Street, Clinton, OK 73601 | 2016-06-20 |
| 1881059434 | Cathrine Mears | Counselor | 94 N 31st, Clinton, OK 73601 | 2015-12-28 |
| 1326464603 | Melissa Lucia Torres | Nurse Practitioner | 3140 W. Hayes, Clinton, OK 73601 | 2014-03-11 |
| 1356789341 | Clinton Hmpn, LLC | Family Medicine | 129 S. 9th Street, Clinton, OK 73601 | 2013-06-12 |
| 1881950970 | Namen Bouma | Counselor | 70-100 N. 31st Street, Clinton, OK 73601 | 2012-04-03 |
| 1366717928 | Sherri Lee Milliron | Counselor | 70-100 N 31st, Clinton, OK 73601 | 2012-03-15 |
| 1740597087 | Susan Kathleen Hodges | Counselor | 19 Sunset Place, Clinton, OK 73601 | 2010-09-08 |
| Find all providers in zip 73601 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336599513 | Kings Royal Care | Point of Service | 8141 Lopez Dr, Clinton, WA 98236-9236 | 2016-06-17 |
| 1275730749 | Mountain View Medical, LLC | Point of Service | 2122 West 1800 North Pmb 413, Clinton, UT 84015 | 2007-06-28 |
| 1255879680 | Changing Minds/changing Lives Home Management & Life Coaching Center | Point of Service | 6300 Edward Dr, Clinton, MD 20735-4135 | 2017-02-06 |
| 1174963581 | Quantum Health Spa | Point of Service | 15 E Main St, Clinton, NJ 08809-1400 | 2013-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184079014 | Raphael Bonelle | Point of Service | 12201 Garden Ct, Oklahoma City, OK 73170-4006 | 2016-04-28 |
| 1972988707 | Sandra Taylor | Point of Service | 906 W 9th Pl. South, Claremore, OK 74017-0000 | 2015-07-22 |
| 1639565153 | Ryian Reyes | Point of Service | 2101 N 14th, Suite 134, Ponca City, OK 74601 | 2015-04-10 |
| 1619374337 | His Arms Extended | Point of Service | 2358 County Road 1325, Blanchard, OK 73010-3522 | 2014-11-24 |
| 1114265576 | National Practitioners Services LLC | Point of Service | 5515 E 76th St, Tulsa, OK 74136-8429 | 2013-01-19 |
| 1962752659 | United Keetoowah Band Community Health Initiative, LLC | Point of Service | 2450 S Muskogee Ave, Tahlequah, OK 74464-5450 | 2012-09-11 |
| 1649547001 | Javersak Family Chiropractic | Point of Service | 1005 Shady Holw, 1005 Shady Hollow Ct, Mcalester, OK 74501-8342 | 2011-11-29 |
| 1588984553 | Mental Health Recovery | Point of Service | 2201 Nw 122nd St Apt 513, Oklahoma City, OK 73120-8405 | 2010-06-01 |
| 1144466962 | Lifeback Chiropractic Plc | Point of Service | 1101 N Harrison St Ste B, Shawnee, OK 74801-5205 | 2008-12-29 |
| 1780858654 | J.michael Wyatt Inc.p.c. | Point of Service | 736 Nw 63rd St, Oklahoma City, OK 73116-7602 | 2008-04-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ANGELWOOD ASSISTED LIVING & MEMORY CARE, LLC.
| 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.