Redwood Place Living Center

NPI #1912092602 in Wetumka, Oklahoma

Provider Information

NPI Number: 1912092602
Entity Type: Organization
Organization Name: Redwood Place Living Center
Primary Specialty: Intermediate Care Facility, Intellectual Disabilities
Enumeration Date: Oct 4, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 623 S ALABAMA ST
City: Wetumka
State: Oklahoma
ZIP Code: 74883-6034
Phone: (405) 452-3271

Authorized Official

Name: MRS. DONNA R SIMMONS
Title: OFFICE MANAGER
Phone: (405) 786-2266

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Intermediate Care Facility, Intellectual Disabilities	315P00000X	Primary

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