EIDETIK OF WELEETKA LLC NPI 1649490244

NPI Information

EIDETIK OF WELEETKA, LLC is an intermediate care facility mentally retarded in Henryetta, OK. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. EIDETIK OF WELEETKA, LLC NPI is 1649490244. The provider is registered as an organization entity type.
The provider Other Name Is The Reach Corporation.

The provider's business location address is:

1201 W TRUDGEON ST
HENRYETTA, OK
ZIP 74437-007
Phone: (918) 650-9393
Fax: (918) 650-0270

The provider's authorized official is Laila Beaven .
The authorized official title is Registered Agent and has the following contact phone number (270) 389-1919.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 12/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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