SERVANT LIVING CENTER - BEGGS, LLC (NPI# 1376075051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376075051 |
| Entity Type | Organization |
| Organization Name | SERVANT LIVING CENTER - BEGGS, LLC |
| Other Organization Name | COUNTRY LANE COTTAGE 5 |
| Practice Address |
511 N Chippewa Beggs OK 74421-2053 |
| Mailing Address |
3325 French Park Dr Suite 6 Edmond OK 73034-7277 |
| Practice Telephone | 9182673362 |
| Practice Fax Number | 4055639447 |
| Mailing Telephone | 4052858166 |
| Mailing Fax Number | 4055639447 |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |
| Authorized Official Name | SCOTT PILGRIM (MEMBER) |
| Authorized Official Telephone | 4052858166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
NH5619 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | NH5619 | 05 |
| Other Name | Type Code |
|---|---|
| Country Lane Cottage 5 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003934076 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 301 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1568580538 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 302 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1194843169 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 303 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1912025982 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 304 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| Street Address |
511 N CHIPPEWA |
| City | BEGGS |
| State | OK |
| Zip Code | 74421-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386978740 | Katherine Rene Dossey | Pharmacist | 8054 Hwy 16 #100, Beggs, OK 74421 | 2009-10-01 |
| 1003934076 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 301 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1568580538 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 302 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1366465247 | Servant Living Center-beggs, LLC | Intermediate Care Facility, Mentally Retarded | 306 E 7th St, Beggs, OK 74421 | 2006-07-25 |
| 1588299499 | Natasha D Mcfalls | Nurse Practitioner | 103 E Main St, Beggs, OK 74421 | 2020-03-11 |
| 1447409206 | Kerri Lee Ellis | Nurse Practitioner | 103 E Main St, Beggs, OK 74421 | 2008-09-16 |
| 1194843169 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 303 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1912025982 | Servant Living Center - Beggs, LLC | Intermediate Care Facility, Mentally Retarded | 304 E 7th St, Beggs, OK 74421 | 2007-03-27 |
| 1750821658 | Monica Ann Kirkendoll | Nurse Practitioner | 103 E Main St, Beggs, OK 74421-0478 | 2017-02-27 |
| 1952497794 | Kenneth Clayton Kern | Family Medicine | 103 E Main, Beggs, OK 74421-0478 | 2006-10-05 |
| Find all providers in zip 74421 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497294714 | Joyce Faye's House | Custodial Care Facility | 2126 Meench Dr, Moore, OK 73170-7494 | 2017-02-20 |
| 1518312404 | Serenity Residential Home Care | Custodial Care Facility | 1129 N Harvard Ave, Oklahoma City, OK 73127-4021 | 2016-04-28 |
| 1366780280 | A Place Close To Home Adult Day Care | Custodial Care Facility | 12220 S State Highway 51, Coweta, OK 74429-7169 | 2013-01-28 |
| 1457620221 | 202 Haley Inc. | Custodial Care Facility | 2911 N Grand St, Enid, OK 73701-1320 | 2011-12-22 |
| 1801170139 | Jenesis Care Homes, Inc | Custodial Care Facility | 8234 S Sandusky Ave, Tulsa, OK 74137-1833 | 2011-10-05 |
| 1699121020 | A Brighter Light Residential Care Home LLC | Custodial Care Facility | 2708 S Hemlock Ave, Broken Arrow, OK 74012-0817 | 2016-05-04 |
| 1841577905 | Spanish Cove Housing Authority | Custodial Care Facility | 11 Palm Ave, Yukon, OK 73099-5645 | 2011-11-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.