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SERVANT LIVING CENTER - BEGGS LLC NPI 1376075051


NPI Information

NPI: 1376075051
Provider Name: SERVANT LIVING CENTER - BEGGS, LLC

Doing Business As: COUNTRY LANE COTTAGE 5

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 37D2003283

Address:
511 N CHIPPEWA
BEGGS, OK
ZIP 74421
Phone: (918) 267-3362
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SERVANT LIVING CENTER - BEGGS, LLC is an adult care home custodial care facility in Beggs, OK. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. SERVANT LIVING CENTER - BEGGS, LLC NPI is 1376075051. The provider is registered as an organization entity type.
The provider Is Doing Business As Country Lane Cottage 5.

The provider's business location address is:

511 N CHIPPEWA
BEGGS, OK
ZIP 74421-053
Phone: (918) 267-3362
Fax: (405) 563-9447

The provider's authorized official is Scott Pilgrim .
The authorized official title is Member and has the following contact phone number (405) 285-8166.

The CLIA number assigned to this NPI record is 37D2003283 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2017 and was last updated on 3/31/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care HomeNH5619OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1NH5619MEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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