HELEN FARRIS (NPI# 1134250731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134250731 |
| Entity Type | Organization |
| Organization Name | HELEN FARRIS |
| Other Organization Name | GREEN ACRES RESIDENTIAL CARE HOME |
| Practice Address |
17963 S 543 Road Tahlequah OK 74464 |
| Mailing Address |
Po Box 807 Tahlequah OK 74465-0807 |
| Practice Telephone | 9184568677 |
| Mailing Telephone | 9184560704 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-07-29 |
| Authorized Official Name | HELEN FARRIS (ADMINISTRATOR) |
| Authorized Official Telephone | 9184560704 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
RC-1101-1101 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | STATE LICENSE | RC-1101-1101 | 01 |
| Other Name | Type Code |
|---|---|
| GREEN ACRES RESIDENTIAL CARE HOME | Doing Business As Name - Organization |
| Street Address |
17963 S 543 ROAD |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124359047 | 3c Old Fashion Boarding Home | Assisted Living Facility | 719 S Jim Thorpe Blvd, Nbu 1706, Prague, OK 74864-3505 | 2010-01-15 |
| 1558690792 | Burdine Inc | Assisted Living Facility | 214 S. Fourth St., Red Bird, OK 74458-0096 | 2009-12-17 |
| 1316142722 | Orchard Grove Rcf | Assisted Living Facility | 35010 S 4465 Rd, Vinita, OK 74301-6672 | 2007-06-16 |
| 1407051816 | Rambling Rose Dba Orchard Grove Rcf | Assisted Living Facility | 35164 S 4465 Rd, Vinita, OK 74301-6782 | 2007-06-16 |
| 1801918784 | Fair Oaks Residential Care LLC | Assisted Living Facility | 1330 N 3rd St, Langley, OK 74350 | 2007-04-04 |
| 1538299417 | Sugar Mountain Retreat, Inc. | Assisted Living Facility | 26403 S 581 Rd, Welling, OK 74471-2303 | 2007-03-07 |
| 1588265383 | Randi Lyn Todd | Assisted Living Facility | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2020-11-06 |
| 1083215867 | Robert Frank Tipton Jr. | Assisted Living Facility | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2020-11-06 |
| 1346685542 | Miller's Residential Care, LLC | Assisted Living Facility | 203 N Gunter St, Vinita, OK 74301-2903 | 2013-05-02 |
| 1700114253 | High Cedar Residential Care | Assisted Living Facility | 18601 Cedar Ln, Noble, OK 73068-5915 | 2009-11-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.