INDIAN TERRITORY LONG TERM CARE INC. NPI 1457481426

NPI Information

INDIAN TERRITORY LONG TERM CARE, INC. is a public health or welfare in Tishomingo, OK. INDIAN TERRITORY LONG TERM CARE, INC. NPI is 1457481426. The provider is registered as an organization entity type.
The provider Is Doing Business As Indian Territory Provider Care Plus.

The provider's business location address is:

105 N NESHOBA ST
TISHOMINGO, OK
ZIP 73460-739
Phone: (580) 371-0015
Fax: (580) 371-3204

The provider's authorized official is Jayson Earl Northcutt .
The authorized official title is Chief Operations Officer and has the following contact phone number (580) 371-2106.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 11/20/2008.

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:

Other Identifiers

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