Eidetik of Weleetka, LLC
NPI #1194945790 in Henryetta, Oklahoma
Provider Information
- NPI Number
- 1194945790
- Entity Type
- Organization
- Organization Name
- Eidetik of Weleetka, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- EIDETIK OF WELEETKA, LLC
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Apr 26, 2007
- Last Updated
- Dec 23, 2022
Practice Location
Authorized Official
- Name
- LAILA BEAVEN
- Title
- REGISTERED AGENT
- Phone
- (270) 389-1919
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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