Pennington Creek Life House

LBN: Pennington Creek Life House
Pennington Creek Life House is an health care organization with primary practice located at 801 E Main St , Tishomingo OK 73460-2351. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Pennington Creek Life House can be contacted via phone (580) 371-3776, or through Owens, Jan via phone (580) 371-3776.

Contact Information

Primary practice address
801 E Main St Tishomingo OK 73460-2351
Phone: (580) 371-3776
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Owens, Jan
Phone: (580) 371-3776

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1164771366
LBN Legal business name Pennington Creek Life House
DBA Doing business as
Authorized official Owens, Jan
Entity Organization
Organization subpart 1 No
Enumeration date Sep 4th, 2012
Last updated Sep 4th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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