Servant Living Center - Beggs, LLC

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Beggs, OK

NPI 1003934076 · NPPES record last updated Jul 16, 2008

Key facts

NPI
1003934076
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
NH5616 (OK)
Legal business name
SERVANT LIVING CENTER - BEGGS, LLC
Practice address
301 E 7TH St
Beggs, OK 74421
Phone
(918) 267-3362
Fax
(918) 267-3344
NPI assigned
Mar 27, 2007
Organization subpart
No

Authorized official

Name
Scott Pilgrim
Title
Managing Member
Phone
(405) 285-8166

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Country Lane Cottage 1 (6 organizations share this tax ID)

Locations

301 E 7TH St
Beggs, OK 74421
Phone (918) 267-3362

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NH5616 OK Yes

Addresses

Primary practice location

301 E 7TH St
Beggs, OK 74421

Mailing address

P.O. Box 990
Edmond, OK 73083
Phone (405) 285-8166

Other identifiers

IdentifierTypeStateIssuer
200054610BMedicaidOK

Other names

  • Country Lane Cottage #2 Doing business as

Other providers in Beggs, OK

All providers in Beggs, OK · Intellectual Disabilities Intermediate Care Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.