NPI 1578771879

Indian Territory Health Services

Organisation Custodial Care Facility Tishomingo, OK

Practice location

Address: 105 N Neshoba St, Tishomingo, OK 73460-1739
Phone: (580) 371-2468

Authorised official

Name: Dennis Lee Hendrix
Title: President
Phone: (580) 371-2468

Registered specialties

Custodial Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311Z00000X Licence DC3501-3501 (OK)

Other Custodial Care Facility providers in Oklahoma →

Registry record

NPI: 1578771879
Entity type: Organization
NPI issued: 18 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.