CLETAS COTTAGE DAY TREATMENT CENTER (NPI# 1386815215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386815215 |
| Entity Type | Organization |
| Organization Name | CLETAS COTTAGE DAY TREATMENT CENTER |
| Practice Address |
220 South 5th St Noble OK 73068 |
| Mailing Address |
Po Box 358 527 West Third Street Konawa OK 74849 |
| Practice Telephone | 5809253286 |
| Practice Fax Number | 5809253924 |
| Mailing Telephone | 5809253286 |
| Mailing Fax Number | 5809253924 |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. CASEY H ANSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5809258804 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRAL OKLAHOMA FAMILY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
220 SOUTH 5TH ST |
| City | NOBLE |
| State | OK |
| Zip Code | 73068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508408311 | Marcus Shane Wahl | Registered Nurse | 121morningside Dr., Noble, OK 73068 | 2019-10-14 |
| 1730619180 | Andrea Celia Nicole Arebalo | Homemaker | 7651 180 Th, Noble, OK 73068 | 2017-06-18 |
| 1841729241 | Yoyma Pedroso Lopez | Registered Nurse | 4521 192nd Ave Se, Noble, OK 73068 | 2017-06-08 |
| 1306392543 | Julie Curry | Counselor | 161 Roman Way, Noble, OK 73068 | 2016-08-28 |
| 1245468602 | Zachary D. Moffitt, Dds, Pllc | Dentist | 333 E. Etowah Rd, Noble, OK 73068 | 2009-06-24 |
| 1538311824 | Jessica Kali Dunlap | Physical Therapist | 207 East Elm, Noble, OK 73068 | 2008-10-17 |
| 1497959704 | Jared Russell Smith | Dentist | 1009 Parkwoods Dr, Noble, OK 73068 | 2007-06-12 |
| 1194937904 | Central Ok Family Med Ctr | Clinic/Center | 303 72nd Se, Noble, OK 73068 | 2007-05-04 |
| 1437230331 | City of Noble | Ambulance | 117 N 2nd St, Noble, OK 73068 | 2006-10-18 |
| 1891708418 | Just for Therapy Incorporated | Physical Therapist | 207 Elm, Noble, OK 73068 | 2006-08-14 |
| Find all providers in zip 73068 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174730758 | High Cedar Res. Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18601 Cedar Ln, Noble, OK 73068-5915 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598166803 | Mwindaace Davis | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3304 W Galveston Pl, Broken Arrow, OK 74012-3255 | 2014-09-07 |
| 1467863928 | Independent Nursing | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2113 Ne 2nd St, Moore, OK 73160-8155 | 2014-05-17 |
| 1760782940 | Lxe Counseling Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Quail Rd, Lane, OK 74555 | 2010-10-22 |
| 1225221195 | Muskogee Assoc. for The Rights of Citizens W/developmental Disabled | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 210 E Okmulgee St, Muskogee, OK 74403-5453 | 2007-08-23 |
| 1578760609 | Missy Ann Beets | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 115 N Ethel, Picher, OK 74360 | 2007-07-02 |
| 1609073725 | Vada Arlene Mertens | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 407 16 Blvd Sw, Miami, OK 74354 | 2007-07-02 |
| 1376740019 | Shanon Elizabeth Paxson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 25322 S 603 Rd, Grove, OK 74344 | 2007-06-27 |
| 1578760203 | Alice Faye Eaglin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 31850 So 4320 Rd, Big Cabin, OK 74332 | 2007-06-27 |
| 1912104670 | Lori Fay Oneill | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 321 West South Ave, Vinita, OK 74301 | 2007-06-27 |
| 1730385378 | Rachel Bruner | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27901 W Hwy 16, Bristow, OK 74010 | 2007-06-21 |
| 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.