| Loebner Enterprises Llc | |
|
1221 E 33rd St Tulsa OK 74105-2043 | |
| (918) 607-1133 | |
| Not Available |
| Full Name | Loebner Enterprises Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1221 E 33rd St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Lynn Loebner (SOLE MBR) |
| Authorized Official Contact | 9186071133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loebner Enterprises Llc Po Box 1764 Boulder CO 80306-1764 Ph: (918) 607-1133 | Loebner Enterprises Llc 1221 E 33rd St Tulsa OK 74105-2043 Ph: (918) 607-1133 |
| NPI Number | 1508108028 |
|---|---|
| Provider Enumeration Date | 03/22/2013 |
| Last Update Date | 03/22/2013 |
| Medicare PECOS PAC ID | 8426328675 |
|---|---|
| Medicare Enrollment ID | O20170720000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508108028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0369 (Oklahoma) | Primary |
| Provider Name | Lynn Loebner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548599756 PECOS PAC ID: 0749550093 Enrollment ID: I20170720000073 |
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