Indian Territory Health Services

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

DC3501-3501 Issued in OK

Legal business name

INDIAN TERRITORY HEALTH SERVICES

Doing business as

Indian Territory Adult Days Services

Practice address

105 N Neshoba St
Tishomingo, OK 73460-1739

Phone

(580) 371-2468

NPI assigned

May 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dennis Lee Hendrix

Title

President

Phone

(580) 371-2468

Specialties & licenses 1

Addresses

Other names 1

• Indian Territory Adult Days Services Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578771879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N NESHOBA ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734601739",
            "telephone_number": "580-371-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N NESHOBA ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734601739",
            "telephone_number": "580-371-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN TERRITORY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-371-2468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "OK",
            "license": "DC3501-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Territory Adult Days Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsea Hull
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• Ranada Hulsey, LPC
• Indian Territory Home Health and Hospice Inc. (Tishomingo Family Medical Center)
• Indian Territory Home Health Inc (Indian Territory Durable Medical Equipment)
• Indian Territory Long Term Care, Inc. (Indian Territory Provider Care Plus)
• Indian Territory Long Term Care, Inc. (Indian Territory Provider Care Plus)
• Indian Territory Long Term Care, Inc. (Indian Territory Provider Care PLus)

• Custodial Care Facility in Tishomingo, OK
• Providers in Tishomingo, OK by specialty
• Custodial Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.