Eidetik of Weleetka, LLC

NPI #1386864981 in Henryetta, Oklahoma

Provider Information

NPI Number
1386864981
Entity Type
Organization
Organization Name
Eidetik of Weleetka, LLC
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Apr 26, 2007
Last Updated
Jan 27, 2023

Practice Location

Address
1201 W TRUDGEON
ZIP Code
74437-4007
Phone
(918) 650-9393

Authorized Official

Name
LAILA M BEAVEN
Title
REGISTERED AGENT
Phone
(270) 389-1919

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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