Organization
SERVANT LIVING CENTER - BEGGS, LLC
Active
Other names
Country Lane Cottage #2
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT PILGRIM (MANAGING MEMBER)
(405) 285-8166
Entity
Organization
Contact information
Practice address
301 E 7TH ST, BEGGS, OK 74421
(918) 267-3362
(918) 267-3344
Mailing address
P.O. BOX 990, EDMOND, OK 73083
(405) 285-8166
(405) 285-8177
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
NH5616
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200054610B
—
OK
Enumeration date
03/27/2007
Last updated
07/16/2008
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