OrganizationActive
Indian Territory Long Term Care, Inc.
NPI 1457481426 · Public Health or Welfare Agency · Tishomingo, OK
Provider details
- NPI number
- 1457481426
- Entity type
- Organization
- Primary specialty
- Public Health or Welfare AgencyAgencies
- Organization subpart
- No
- Authorized official
- Jayson Northcutt, Chief Operations Officer(580) 371-2106
- License
- 100627980B (OK)
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
105 N Neshoba St
Tishomingo, OK 73460-1739
Phone: (580) 371-0015
Fax: (580) 371-3204
Street-level locationGet directions
Mailing address
105 N Neshoba St
Tishomingo, OK 73460-1739
Other names (DBA / former)
- Doing business as
- Indian Territory Provider Care Plus
Registry dates
- Enumerated
- 2007-03-07
- Last updated
- 2008-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.