| Organization Name: | INDIAN TERRITORY HOME HEALTH AND HOSPICE III, LLC |
| NPI Number: | 1194833806 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDY GATES (PRESIDENT) |
| Mailing Address: | 121 S Broadway St Hugo |
| State: | OK US |
| Postal Code: | 747434417 |
| Phone Number: | 8555277473 |
| Fax Number: | 5809316920 |
| NPI Enumeration Date: | 08/25/2006 |
| NPI Last Update Date: | 11/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 100262450I |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |