OrganizationActive
Pennington Creek Life House
NPI 1922246115 · Community/Behavioral Health Agency · Coalgate, OK
Provider details
- NPI number
- 1922246115
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Jan Wyatt, Clinical Director(580) 310-4164
- License
- 3877 (OK)
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
8 S Michigan St Ste B
Coalgate, OK 74538-2825
Phone: (580) 310-4164
Street-level locationGet directions
Mailing address
Po Box 261
Fittstown, OK 74842-0261
Registry dates
- Enumerated
- 2009-01-27
- Last updated
- 2009-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.