=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437164969
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDIAN TERRITORY HOME HEALTH & HOSPICE III, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2006
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4815 S HARVARD AVE STE 300
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74135-3067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-960-2888
-----------------------------------------------------
Fax | 918-933-4323
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3010 LYNDON B JOHNSON FWY STE 1100
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-2712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-379-1600
-----------------------------------------------------
Fax | 903-537-8420
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COMPLIANCE,PRIVACY,& SAFETY OFFICER
-----------------------------------------------------
Name | KATIE MONASTIERE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 517-768-4373
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 7757
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------