3C Old Fashion Boarding Home – Assisted Living Facility (Mental Illness), NPI 1124359047

3C Old Fashion Boarding Home is a healthcare provider. based in Prague, Oklahoma. specializing in Assisted Living Facility (Mental Illness). The NPI Number for 3C Old Fashion Boarding Home is 1124359047

Main info

Organization
Name
3C Old Fashion Boarding Home
NPI
1124359047
Phone
(405) 567-2280
Address
719 S JIM THORPE BLVD
Authorized Official
JVON COOK OWNER
Enumeration Date
15 January 2010
Last Update Date
15 January 2010
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness80
Years active:16State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for 3C Old Fashion Boarding Home

  • Jim Thorpe Boulevard, Prague, Lincoln County, Oklahoma, 74864, United States

    NBU 1706

    PRAGUE, OK 748643505

    Phone: (405) 567-2280

    Fax: (405) 567-2280

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74864)

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Reviews

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Frequently asked questions

How do I look up 3C Old Fashion Boarding Home by NPI?
Use NPI 1124359047 when you need to reference 3C Old Fashion Boarding Home in forms, claims, or directories.
Is 3C Old Fashion Boarding Home's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does 3C Old Fashion Boarding Home work in?
You can think of 3C Old Fashion Boarding Home as practicing within Assisted Living Facility (Mental Illness). Clinical services aligned with this taxonomy classification.
What location metadata exists for 3C Old Fashion Boarding Home?
The page summarizes Prague, Oklahoma for 3C Old Fashion Boarding Home; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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