OrganizationActive
Peak Medical Oklahoma No. 12, Inc.
NPI 1851346142 · Intellectual Disabilities Intermediate Care Facility · Henryetta, OK
Provider details
- NPI number
- 1851346142
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Sunbridge Healthcare Corporation
- Organization subpart
- Yes
- Authorized official
- William Mathies, President Director(505) 821-3355
- License
- NH56055605 (OK)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
600 Lake Rd
Henryetta, OK 74437-5415
Phone: (918) 652-8101
Fax: (918) 652-8209
Street-level locationGet directions
Mailing address
101 Sun Ave Ne
Albuquerque, NM 87109-4373
Other names (DBA / former)
- Doing business as
- Lake Drive Home
Registry dates
- Enumerated
- 2006-05-24
- Last updated
- 2009-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.