OrganizationActive
State of Oklahoma Dept. of Human Services
NPI 1295828895 · Intellectual Disabilities Intermediate Care Facility · Pauls Valley, OK
Provider details
- NPI number
- 1295828895
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- William Johnson, Programs Manager(405) 521-3565
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
Rt. 1 Box 44-A
Pauls Valley, OK 73075
Phone: (405) 238-6401
Approximate (ZIP-level) locationGet directions
Mailing address
Rt. 1 Box 44-A
Pauls Valley, OK 73075
Other names (DBA / former)
- Other name
- Souther Oklahoma Resource Center
Registry dates
- Enumerated
- 2006-10-02
- 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.