| NPI | 1710501499 |
|---|---|
| Doing Business As | EASTOK COTTAGE #1 |
| Entity Type | Organization |
| Authorized Contact | SCOTT PILGRIM Manager 405-285-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-06-05 |