OrganizationActive
Okmulgee Terrace, LLC
NPI 1093816100 · Intellectual Disabilities Intermediate Care Facility · Sallisaw, OK
Provider details
- NPI number
- 1093816100
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Moran, Business Management(918) 775-4439
- License
- NH5607-5607 (OK)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 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
210 East Choctaw Street
Sallisaw, OK 74955-0429
Phone: (918) 775-4439
Fax: (918) 775-9242
Street-level locationGet directions
Mailing address
Po Box 429
Sallisaw, OK 74955-0429
Registry dates
- Enumerated
- 2006-09-25
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.