OrganizationActive
Eidetik of Weleetka, LLC
NPI 1003036609 · Intellectual Disabilities Intermediate Care Facility · Henryetta, OK
Provider details
- NPI number
- 1003036609
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Laila Beaven, Registered Agent(270) 389-1919
- License
- 100770750A (OK)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1201 W Trudgeon St
Henryetta, OK 74437-4007
Phone: (918) 650-9393
Fax: (918) 650-0270
Street-level locationGet directions
Mailing address
1201 W Trudgeon St
Henryetta, OK 74437-4007
Other names (DBA / former)
- Doing business as
- Creek Place
- Other name
- The Reach Corporation-Name to Be Changed to
Registry dates
- Enumerated
- 2007-04-26
- Last updated
- 2022-12-21
- Certified
- 2022-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.