Parker Place Home 2, LLC.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

PARKER PLACE HOME 2, LLC.

Practice address

7514 NW Sun Blvd.
Lawton, OK 73505

Phone

(940) 337-6777

NPI assigned

Feb 1, 2022

Organization subpart

Yes

Parent organization

PARKER PLACE LIVING CENTERS, LLC.As reported in NPPES

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

Authorized official

Name

Mrs. Sally Heather Clement, LNHA

Title

Owner/Administrator

Phone

(940) 337-6777

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194478941. Details of each certification follow.

• CCN 37G176 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 37G176

Legal name

PARKER PLACE HOME 2, LLC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Feb 15, 2023

Last certification

Jul 11, 2025

Beds

16

Ownership / control type

Private (proprietary)

Facility address

7514 NW Sun Boulevard
Lawton, OK 73505

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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.

• Francois J Dutoit, MD

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1760477509
  NPD (past)
• Mona Jean Nickerson, APRN, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Ada, OK
  • NPI 1154734994
  NPD (past)

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1194478941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7510 NW SUN BLVD.",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "940-337-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 NW SUN BLVD.",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "940-337-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKER PLACE HOME 2, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARKER PLACE LIVING CENTERS, LLC.",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "CLEMENT",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "940-337-6777",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vrajesh M Parikh, MD
• Park Ridge Physical Therapy, P.C.
• Jordan T Park
• SE Hun Park, ATC
• Parker Place Home 1, LLC.
• Alexandra Parker
• Rebecca Ann Parker
• Timothy Leroy Parker Jr.
• Jessica Parks, LPN
• Brenda Michele Parra

• Intellectual Disabilities Intermediate Care Facility in Lawton, OK
• Providers in Lawton, OK by specialty
• Intellectual Disabilities Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.