Organization
INDIAN TERRITORY HEALTH SERVICES
Active
Other names
Indian Territory Adult Days Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS LEE HENDRIX (PRESIDENT)
(580) 371-2468
Entity
Organization
Contact information
Practice address
105 N NESHOBA ST, TISHOMINGO, OK 73460-1739
(580) 371-2468
Mailing address
105 N NESHOBA ST, TISHOMINGO, OK 73460-1739
(580) 371-2468
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
DC3501-3501
OK
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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