Organization Active NPI

Aspen Place Living Center, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Weleetka, OK
National Provider Identifier
1104908342
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
NH3209-3209 Issued in OK
Legal business name
ASPEN PLACE LIVING CENTER, LLC
Practice address
202 E First St
Weleetka, OK 74883
Phone
(405) 452-3271
Fax
(405) 452-5154
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Donna R Simmons
Title
Office Manager
Phone
(405) 786-2266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NH3209-3209 OK Primary

Addresses

Primary practice location

202 E First St
Weleetka, OK 74883

Mailing address

PO Box 488
Weleetka, OK 74880-0488
Phone (405) 786-2266

Other names 1

  • Adkins LP, dba Aspen Place Former legal business name

National Provider Directory

National Provider Directory

Locations

202 E 1st St
Wetumka, OK 74883
Phone (405) 452-3205

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104908342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "WELEETKA",
            "state": "OK",
            "postal_code": "748800488",
            "telephone_number": "405-786-2266",
            "fax_number": "405-786-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E FIRST ST",
            "city": "WELEETKA",
            "state": "OK",
            "postal_code": "74883",
            "telephone_number": "405-452-3271",
            "fax_number": "405-452-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN PLACE LIVING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-786-2266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OK",
            "license": "NH3209-3209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adkins LP, dba Aspen Place",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Weleetka, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.