# AUTUMN WOOD OPCO, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184059982
- **Authorized official:** THERESA MERE (ASSOCIATE)
- **Authorized official phone:** (325) 691-5591

## Contact information

- **Practice address:** 2700 N HICKORY ST, CLAREMORE, OK 74017-1214
- **Practice address phone:** (918) 283-4949
- **Practice address fax:** (918) 283-4508
- **Mailing address:** 2700 N HICKORY ST, CLAREMORE, OK 74017-1214
- **Mailing address phone:** (918) 283-4949
- **Mailing address fax:** (918) 283-4508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | NH6609 | OK | — |
| 314000000X | Skilled Nursing Facility | 375553 | OK | Yes |

## Other

- **Enumeration date:** 09/11/2013
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200478150A | — | OK |