Indian Territory Provider Care Plus

LBN: Indian Territory Long Term Care, Inc.
Indian Territory Provider Care Plus is an health care organization with primary practice located at 105 N Neshoba St , Tishomingo OK 73460-1739. The organization recently has only one registered license in Agencies / Public Health or Welfare, which is considered as the primary health care specialty. Indian Territory Long Term Care, Inc. can be contacted via phone (580) 371-0015, or through Northcutt, Jayson Earl via phone (580) 371-2106.

Contact Information

Primary practice address
105 N Neshoba St Tishomingo OK 73460-1739
Phone: (580) 371-0015
Fax: (580) 371-3204
Website:
Map and Directions
Authorized official contact:
Name: Northcutt, Jayson Earl
Phone: (580) 371-2106

Health care specialties

SpecialtyCodeLicense #State
Agencies / Public Health or Welfare 251K00000X 100627980B Oklahoma

Profile Details

NPI number 1457481426
LBN Legal business name Indian Territory Long Term Care, Inc.
DBA Doing business as Indian Territory Provider Care Plus
Authorized official Northcutt, Jayson Earl
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2007
Last updated Nov 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457481426 NPPES
Oklahoma MEDICAID 100627980B

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