SUGAR MOUNTAIN RETREAT, INC. (NPI# 1538299417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538299417 |
| Entity Type | Organization |
| Organization Name | SUGAR MOUNTAIN RETREAT, INC. |
| Practice Address |
26403 S 581 Rd Welling OK 74471-2303 |
| Practice Telephone | 9184574221 |
| Mailing Telephone | 9184561010 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVETTA MCINTOSH (ADMINISTRATOR) |
| Authorized Official Telephone | 9184574221 |
| 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 0201-0201 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | STATE LICENSE | RC 0201-0201 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326375379 | Sugar Mountain Retreat, Inc. | Assisted Living Facility | 27753 S Welling Rd, Welling, OK 74471-2202 | 2009-11-12 |
| Street Address |
26403 S 581 RD |
| City | WELLING |
| State | OK |
| Zip Code | 74471-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922206382 | Sue Ella Dalrymple | Homemaker | 23315 E 830 Rd, Welling, OK 74471 | 2007-07-06 |
| 1407031214 | Hope Dupre Owen | Advanced Practice Midwife | 20432 S 560 Rd, Welling, OK 74471-2006 | 2007-12-31 |
| 1366713794 | Janus Farar | Counselor | 23463 E 774 Rd, Welling, OK 74471-2013 | 2012-01-17 |
| 1396757217 | Onward and Upward Incorporated | Speech-Language Pathologist | 23047 E 830 Rd, Welling, OK 74471-2144 | 2006-08-12 |
| 1811149933 | Linda Lavelle White | Speech-Language Pathologist | 23047 E 830 Rd, Welling, OK 74471-2144 | 2008-10-21 |
| 1396917027 | Mary Elaine Rainwater | Speech-Language Pathologist | 23047 E 830 Rd, Welling, OK 74471-2144 | 2008-04-02 |
| 1881894301 | Christy Dawn Steele | Occupational Therapist | 23047 E 830 Rd, Welling, OK 74471-2144 | 2007-07-23 |
| 1699977066 | Patricia Ann Daniel | Occupational Therapist | 23047 E 830 Rd, Welling, OK 74471-2144 | 2007-06-05 |
| 1942215561 | Lake Country Healthcare LLC | Pharmacy | 27753 S Welling Rd, Welling, OK 74471-2202 | 2006-07-30 |
| 1477117620 | Heather Michelle Taylor | Case Manager/Care Coordinator | 27753 S Welling Rd, Welling, OK 74471-2202 | 2019-04-23 |
| Find all providers in zip 74471 | ||||
| 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 |
|---|---|---|---|---|
| 1992835888 | Lake Francis Residential Care Home, LLC | Assisted Living Facility | 27753 S Welling Rd, Welling, OK 74471-2202 | 2007-03-07 |
| 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 |
| 1134250731 | Helen Farris | Assisted Living Facility | 17963 S 543 Road, Tahlequah, OK 74464 | 2007-03-08 |
| 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.