Organization
PADDINGTON PLACE, LLC
Active
Other names
Paddington Place Cottages 1-4
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT D PILGRIM (MANAGING MEMBER)
(405) 285-8166
Entity
Organization
Contact information
Practice address
76 RACHEL STREET, BIXBY, OK 74008
(918) 290-3401
(539) 302-9786
Mailing address
PO BOX 990, EDMOND, OK 73083-0990
(405) 285-8166
(405) 563-9447
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201013670A
—
OK
05
—
201013680A
—
OK
Enumeration date
06/08/2020
Last updated
08/15/2024
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