Lake Francis Residential Care Home, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

RC 0101-0101 Issued in OK

Legal business name

LAKE FRANCIS RESIDENTIAL CARE HOME, LLC

Practice address

27753 S Welling Rd
Welling, OK 74471-2202

Phone

(918) 422-9907

NPI assigned

Mar 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marsena McIntosh

Title

Administrator

Phone

(918) 457-5535

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Lake Francis Residential Care Home LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lake Francis Residential Care LLC

  • Assisted Living Facility
  • Welling, OK
  • NPI 1144557190
  NPD tax ID

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992835888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27753 S WELLING RD",
            "city": "WELLING",
            "state": "OK",
            "postal_code": "744712202",
            "telephone_number": "918-457-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27753 S WELLING RD",
            "city": "WELLING",
            "state": "OK",
            "postal_code": "744712202",
            "telephone_number": "918-422-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FRANCIS RESIDENTIAL CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "MARSENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-457-5535"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "OK",
            "license": "RC 0101-0101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RC 0101-0101",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Kelley
• Sarah Nicole Kelley, BSW
• Autumn Ketcher
• Anita Sue Kilgore
• Lake Country Healthcare LLC
• Lake Francis Residential Care LLC
• Chelsea Allece Lechner
• Jason Ray Lechner, MS LPC-C
• Susan Dean Littlejohn, BA
• Amanda Jo Long

• Assisted Living Facility (Mental Illness) in Welling, OK
• Providers in Welling, OK by specialty
• Assisted Living Facility (Mental Illness) in Oklahoma

• 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.