LIFE PACE, INC. (NPI# 1023407376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023407376 |
| Entity Type | Organization |
| Organization Name | LIFE PACE, INC. |
| Practice Address |
902 E Pine St Tulsa OK 74106-5928 |
| Mailing Address |
5950 E 31st St Tulsa OK 74135-5114 |
| Practice Telephone | 9186649000 |
| Mailing Telephone | 9186649000 |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |
| Authorized Official Name | KATHLEEN M PALMER (CHIEF FINANCIAL & OPERATING OFFICER) |
| Authorized Official Telephone | 9186649000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | H6941 | OK | Agencies |
| Street Address |
902 E PINE ST |
| City | TULSA |
| State | OK |
| Zip Code | 74106-5928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588633028 | John Robert Gray Jr. | Family Medicine | 902 E Pine St, Tulsa, OK 74106-5928 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811538895 | Desma Johnson | Technician | 784 East 43rd Street North, Tulsa, OK 74106 | 2019-10-01 |
| 1912462094 | Breyan Lashawn Jackson | Case Manager/Care Coordinator | 3606 N Mlk Jr. Blvd, Tulsa, OK 74106 | 2019-02-04 |
| 1740751445 | Ernest Kaara Maina | Family Medicine | 3606 M.l.k. Jr Blvd, Tulsa, OK 74106 | 2018-12-07 |
| 1568969632 | A&m Healthcare Clinic | Nurse Practitioner | 3606 North Mlk Blvd, Tulsa, OK 74106 | 2018-04-06 |
| 1265880819 | Paula Patricia Tullis | Psychologist | 1232 N Boston, Tulsa, OK 74106 | 2016-05-24 |
| 1326413030 | Eartha Mcalester | Counselor | 628 E. Virgin St., Tulsa, OK 74106 | 2015-12-07 |
| 1114334182 | James O Brannon Jr. | Behavioral Analyst | 2745 North Main, Tulsa, OK 74106 | 2014-07-22 |
| 1952718512 | Teresa Marie Williams | Counselor | 3601 N. Martin Luther King Blvd, Tulsa, OK 74106 | 2014-07-16 |
| 1639580764 | Lynnette Dixon | Case Management | 708 East 38th Street North, Tulsa, OK 74106 | 2014-05-12 |
| 1184975898 | Tiara Delonia | Social Worker | 1 W 36th St N Suite 1, Tulsa, OK 74106 | 2012-09-21 |
| Find all providers in zip 74106 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952584518 | Cherokee Nation Comprehensive Care Agency | PACE Provider Organization | 1387 W Fourth St, Tahlequah, OK 74464 | 2007-12-06 |
| 1447379284 | Inca Commnity Services, Inc. | PACE Provider Organization | 301 W 10th St, Atoka, OK 74525-2800 | 2007-03-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.