The Reach Corporation Third Place

LBN: Eidetik Of Weleetka, Llc
The Reach Corporation Third Place is an health care organization with primary practice located at 1201 W Trudgeon , Henryetta OK 74437-4007. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Eidetik Of Weleetka, Llc can be contacted via phone (918) 650-9393, or through Beaven, Laila M via phone (270) 389-1919.

Contact Information

Primary practice address
1201 W Trudgeon Henryetta OK 74437-4007
Phone: (918) 650-9393
Fax: (918) 650-0270
Website:
Map and Directions
Authorized official contact:
Name: Beaven, Laila M
Phone: (270) 389-1919

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 100769950A Oklahoma

Profile Details

NPI number 1386864981
LBN Legal business name Eidetik Of Weleetka, Llc
DBA Doing business as The Reach Corporation Third Place
Authorized official Beaven, Laila M
Entity Organization
Organization subpart 1 No
Enumeration date Apr 26th, 2007
Last updated Jan 27th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386864981 NPPES
Oklahoma MEDICAID 100769950A

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