NPIMap

Organization Active NPI

State of Oklahoma Human Services

Doing business as Robert M. Greer Center/Suite C-Building 3

  • Intellectual Disabilities Intermediate Care Facility
  • Enid, OK
National Provider Identifier
1104618412
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
STATE OF OKLAHOMA HUMAN SERVICES
Doing business as
Robert M. Greer Center/Suite C-Building 3
Practice address
2616 North 30TH Street
Enid, OK 73701-8760
Phone
(580) 213-2700
Fax
(580) 358-8013
NPI assigned
May 21, 2025
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. David Ewing, LNHA
Title
Licensed Nursing Home Administrator
Phone
(580) 805-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

2616 North 30TH Street
Enid, OK 73701-8760

Mailing address

2616 North 30TH Street
Enid, OK 73701-8760
Phone (580) 213-2700

Other identifiers 1

IdentifierTypeStateIssuer
100769310-AMedicaidOK

Other names 1

  • Robert M. Greer Center/Suite C-Building 3 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Community M141 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

2616 N 30th St
Enid, OK 73701
Phone (580) 213-2700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1104618412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 NORTH 30TH STREET",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737018760",
            "telephone_number": "580-213-2700",
            "fax_number": "580-358-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 NORTH 30TH STREET",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737018760",
            "telephone_number": "580-213-2700",
            "fax_number": "580-358-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "EWING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "LICENSED NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "580-805-1400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100769310-A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert M. Greer Center/Suite C-Building 3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.