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Lake Drive Health Care Llc
Intellectual Disabilities Intermediate Care Facility in Henryetta, Oklahoma
NPI 1598002966

Lake Drive Health Care Llc is a Intellectual Disabilities Intermediate Care Facility based in Henryetta, OK. Lake Drive Health Care Llc practices in Henryetta, OK. The NPI Number for Lake Drive Health Care Llc is 1598002966 and holds a License No. NH5605 (Oklahoma).

The current practice location address for Lake Drive Health Care Llc is 600 Lake Rd, Henryetta, OK and can be reached out via phone at 918-652-8101 and via fax at 918-652-0253.

Location: 600 Lake Rd, Henryetta, OK, 74437-5415
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598002966
Provider Name
Lake Drive Health Care Llc
Credential
Provider Entity Type
Organization
Address
600 Lake Rd, Henryetta, OK, 74437-5415
Phone Number
918-652-8101
Fax Number
918-652-0253
Provider Enumeration Date
01/05/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100779100A 05 OK
institution
Provider Business Practice Location Address Details
Address
600 Lake Rd
City
Henryetta
State
Oklahoma
Zip
74437-5415
Phone Number
918-652-8101
Fax Number
918-652-0253
person
Provider Business Mailing Address Details
Address
600 Lake Rd
City
Henryetta
State
Oklahoma
Zip
74437-5415
Phone Number
918-652-8101
Fax Number
918-652-0253
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
NH5605 (Oklahoma)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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Intellectual Disabilities Intermediate Care Facility
600 Lake Rd,
HENRYETTA, OK
74437-5415
918-652-8101
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