Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Willow Place Living Center, LLC

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1366524423

Willow Place Living Center, LLC is an Intellectual Disabilities Intermediate Care Facility in Wetumka, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2006.

Licensed in
OK
In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

622 S Alabama St
Wetumka, OK 74883
Phone: (405) 452-3278
Fax: (405) 452-5154
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence NH3203-3203 (OK)

Record details

NPI number1366524423
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donna Simmons — Office Manager · (405) 380-6671
Other names Willow Place
NPI enumeratedOctober 19, 2006
Last updated in NPPESJanuary 12, 2023
Certification dateJanuary 12, 2023
Mailing addressPo Box 488, Weleetka, OK 74880-0488

Other providers in Wetumka