{"npi":"1992925598","type":"NPI-2","status":"active","name":{"display":"Eidetik Of Weleetka","other":[],"organization_name":"EIDETIK OF WELEETKA","authorised_official":"Laila Beaven"},"specialty":{"primary_taxonomy":"315P00000X","primary_taxonomy_description":"Intellectual Disabilities Intermediate Care Facility","slug":"intellectual-disabilities-intermediate-care-facility","schema_org_specialty":null,"all":[{"code":"315P00000X","description":"Intellectual Disabilities Intermediate Care Facility","primary":true,"state":"OK","license":"200001070A"}]},"addresses":[{"purpose":"LOCATION","street_1":"1201 W TRUDGEON ST","city":"HENRYETTA","state":"OK","postal_code":"744374007","country_code":"US","phone":"9186509393","fax":"9186500270"},{"purpose":"MAILING","street_1":"P.O. BOX 525","city":"MORGANFIELD","state":"KY","postal_code":"42437","country_code":"US","phone":"2703891919","fax":"2703891963"}],"license":{"state":"OK","number":"200001070A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"200001070A","state":"OK","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2007-04-26","last_updated":"2023-02-22","_meta":{"source":"NPPES","snapshot_date":"2023-02-22","doc_url":"https://findmynpi.com/api"}}